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Journal of Affective Disorders
Journal Prestige (SJR): 2.053
Citation Impact (citeScore): 4
Number of Followers: 18  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0165-0327
Published by Elsevier Homepage  [3161 journals]
  • Relationship between posttraumatic stress symptoms, caregiving response,
           and parent mental health in youth exposed to single incident trauma
    • Abstract: Publication date: 15 May 2019Source: Journal of Affective Disorders, Volume 251Author(s): E. Goddard, J. Onwumere, R. Meiser-Stedman, E. Sutherland, P. Smith BackgroundFamily factors may alter the risk of developing posttraumatic stress disorder (PTSD) or depression in young people after a traumatic event, but it is not clear which modifiable family variables can be addressed in psychological therapies. This study examined the relationships between family factors (Expressed Emotion [EE] and family accommodation) and psychopathology (posttraumatic stress symptoms; PTSS) in young people following a single incident trauma. Potential mediators of these relationships were also investigated.MethodSixty-six parent-child dyads (aged 8–17 years) were assessed within one month of attending an Emergency Department. Self-reported PTSS and perceived EE were assessed in young people. Parents’ own PTSS, mood symptoms, EE, and accommodating behaviours were also assessed.ResultsCross-sectional analyses revealed that young person-perceived EE, parent-reported emotional over involvement (EOI) and accommodation behaviours significantly predicted higher PTSS in young people. The stress experienced as a consequence of EE mediated the relationship between young person-perceived EOI and PTSS in young people. Parental PTSS and anxiety were positively correlated with EOI and accommodation. Parental PTSS was not significantly associated with symptoms in young people.ConclusionsThe results support the hypothesis that EE and accommodation are positively associated with PTSS in young people in the month following a potentially traumatic event. Understanding the child in the context of their family environment and relationships offers an important framework for making sense of and facilitating adaptive adjustment following a traumatic event.
  • Depression and aging with HIV: Associations with health-related quality of
           life and positive psychological factors
    • Abstract: Publication date: 15 May 2019Source: Journal of Affective Disorders, Volume 251Author(s): Alexandra S. Rooney, Raeanne C. Moore, Emily W. Paolillo, Ben Gouaux, Anya Umlauf, Scott L. Letendre, Dilip V. Jeste, David J. Moore, the HIV Neurobehavioral Research Program BackgroundDepression is prevalent among persons living with HIV (PLWH). This study investigated the relationships between depressive symptomatology, health-related quality of life (HRQoL), and positive psychological factors in PLWH and age-matched HIV−individuals.MethodsOne hundred twenty-two PLWH and 94 HIV− individuals, recruited in three age cohorts (36–45, 46–55, 56–65 years old), completed self-report questionnaires on depressive symptoms (CES-D), HRQoL, and positive psychological factors (resilience, grit, and self-rated successful aging [SRSA]). Participants were classified based on HIV status (H+ vs H−) and elevated depressive symptoms (D+ vs D−) into four groups (H+/D+; H−/D+; H+/D−; H−/D−).ResultsFifty-eight percent of PLWH had elevated depressive scores, compared to 33% of HIV- individuals (p 
  • Identifying postnatal depression: Comparison of a self-reported depression
           item with Edinburgh Postnatal Depression Scale scores at three months
    • Abstract: Publication date: 15 May 2019Source: Journal of Affective Disorders, Volume 251Author(s): Gracia Fellmeth, Charles Opondo, Jane Henderson, Maggie Redshaw, Jenny Mcneill, Fiona Lynn, Fiona Alderdice BackgroundEarly identification of postnatal depression is important in order to minimize adverse outcomes. The Edinburgh Postnatal Depression Scale (EPDS) is commonly used as a screening tool but a single, direct question on depression may offer an alternative means of identifying women in need of support. This study examines the agreement between these methods and characteristics of women who self-identify as depressed and those with EPDS ≥ 13.MethodsSecondary analysis of two national maternity surveys conducted in England and Northern Ireland. Agreement between the direct question and EPDS scores was assessed using Cohen's kappa. Logistic regression was used to identify characteristics of women in each group.Results6752 women were included. At three months postpartum, 6.1% of women self-identified as having depression, 9.1% scored EPDS ≥ 13, 2.8% were positive on both. Agreement between the two methods was minimal (Cohen's kappa  40 years (OR 1.8; 95% CI 1.2–2.8). EPDS ≥ 13 was associated with 
  • Baseline serum C-reactive protein levels may predict antidepressant
           treatment responses in patients with major depressive disorder
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Jun Zhang, Yingying Yue, Ashok Thapa, Jianzhong Fang, Shengjun Zhao, Weihua Shi, Zhong Yang, Yanfang Li, Yonggui Yuan BackgroundInflammation has been shown previously to predict antidepressant treatment response. This retrospective study was conducted to test if the baseline serum C-reactive protein (CRP) levels could predict antidepressant treatment responses in a Chinese sample.Methods75 adult inpatients (26 male, 49 female) with major depressive disorder (MDD) diagnosed according to DSM-5 were included in this study. Sociodemographic and clinical features, baseline CRP levels, 17-item Hamilton Depression Rating Scale (HDRS-17) and Hamilton Anxiety Rating Scale (HARS) scores assessed at baseline and weeks 1, 2, 3 and 4 were then collected. Afterwards patients were divided into two groups: the low CRP group (baseline CRP 
  • In vivo molecular chronotyping, circadian misalignment, and high rates of
           depression in young adults
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Chi Nguyen, Gillian Murray, Sarah Anderson, Allan Filipowicz, Krista K Ingram Background: Young adults are disproportionately affected by depression and related mental disorders. Circadian misalignment (a phase advance or delay in the body's internal clock timing) is thought to exert adverse effects on downstream physiological processes regulating mood. Circadian disruption may represent an additional, under-appreciated risk factor affecting young adults. Here, we test the hypothesis that depression in young adults is associated with circadian misalignment—the lack of concordance between an individual's endogenous rhythm and their external social and academic environment.Methods: We screened 528 individuals for morningness-eveningness diurnal preference and sleep-wake chronotype. We selected individuals with extreme scores (n = 130) for estimation of circadian phase by measuring clock gene mRNA oscillations in hair follicles (a peripheral clock). Using an independent, data-driven cluster analysis, we define the circadian misalignment of both advanced- and delayed-phase individuals from clock gene mRNA expression levels. We compare depression (BDI-II), anxiety (STAI), social jetlag, sleep duration, and sleep disturbance (PROMIS) scores between misaligned individuals and control individuals of intermediate chronotype (n = 173).Results: We demonstrate that depression scores in young adults are significantly higher in individuals with circadian phase delays and in individuals with a mismatch between circadian behavioral phenotypes and circadian molecular phase. Evening-type individuals with circadian phase delays are 20 times more likely and mismatched individuals are 5–8 times more likely to be depressed than control individuals. Sleep disturbance shows a similar relationship with circadian phenotypes, but the mood effects described in this study are independent of sleep duration, social jetlag and gender.Limitations: Our study examined peripheral clock genes that represents a circadian rhythm potentially influenced by both intrinsic and external, environmental factors. Our study population spanned a limited age-group and our results cannot distinguish between cause and effect of circadian, sleep and mood variables.Conclusions: Our study validates previous theoretical predictions of circadian effects on mood disorders and highlights a critical, hidden risk factor affecting mood in young adults—circadian disruption.
  • Exploratory analyses of effect modifiers in the antidepressant treatment
           of major depression: Individual-participant data meta-analysis of 2803
           participants in seven placebo-controlled randomized trials
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Hisashi Noma, Toshi A. Furukawa, Kazushi Maruo, Hissei Imai, Kiyomi Shinohara, Shiro Tanaka, Kazutaka Ikeda, Shigeto Yamawaki, Andrea Cipriani BackgroundIt is clinically important to know who are likely to respond more or less to antidepressants. However, meaningful effect modifiers (variables associated with differential response depending on the treatment) are yet to be identified.MethodsWe conducted individual participant data (IPD) meta-analysis and meta-regression to explore effect modifiers in placebo-controlled antidepressant trials conducted so far in Japan.ResultsWe obtained access to IPD from seven placebo-controlled trials comparing bupropion, duloxetine, escitalopram, mirtazapine, paroxetine or venlafaxine with placebo in the acute phase treatment of major depression (total n = 2803). The higher the guilt subscale score of the baseline Hamilton Rating Scale for Depression (HRSD), the greater the difference in reduction in depression severity between the antidepressants and placebo at week 6, while the older the current age or the age at onset, the smaller the difference. At week 8, the guilt subscale score of HRSD and presence of suicidal ideation at baseline predicted greater, and the anhedonia subscale and insomnia subscale scores of HRSD and early response at week 2 predicted smaller, difference in reduction.LimitationsDifferent studies measured different sets of baseline variables and we were able to analyze only a limited set of candidate variables for effect modification.ConclusionAge, age at onset, several HRSD subscales including guilt, anhedonia and insomnia, presence of suicidal ideation at baseline and early response are potential effect modifiers for response to antidepressants in the acute phase antidepressant treatment of major depression. Future trials need to measure these and additional variables in concerted efforts to enable matching of treatments with individual characteristics in depression.
  • Depression related cerebral pathology and its relationship with cognitive
           functioning: A systematic review
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Alec Jamieson, Alicia M. Goodwill, Mario Termine, Stephen Campbell, Cassandra Szoeke BackgroundDepression's relationship with cerebral abnormalities and cognitive decline is temporally dynamic. Despite clear clinical utility, understanding depression's effect on cerebral structures, cognitive impairment and the interaction between these symptoms has had limited consideration.MethodsThis review summarised studies examining a clinical depression diagnosis or validated scales measuring depressive symptoms, data concerning amyloid-beta (Aβ) levels, brain structure and function focusing on hippocampal alterations, or white matter hyperintensities (WMH), and at least one validated neuropsychological test. Online database searches of: PsycINFO, EMBASE, MEDLINE, and Scopus were conducted to identify potential articles.ResultsWhile depression was consistently associated with cross-sectionally cognitive decline across multiple domains, the neuropathological basis of this dysfunction remained unclear. Hippocampal, frontal, and limbic dysfunction as well as cortical thinning, WMH, and Aβ burden all provide inconsistent findings, likely due to depression subtypes. The consistency of these findings additionally decreases when examining this relationship longitudinally, as these results are further confounded by pre-dementia states. The therapeutic interventions examined were more efficacious in the younger compared with the older samples, who were characterised by greater WMH and Aβ burden.LimitationsThe limited number of longitudinal and interventional studies in addition to the heterogeneity of the samples restricts their generalisability.ConclusionsSymptomatological differences between early-onset and late-onset depression (EOD and LOD) appear crucial in understanding whether late-life depression is the primary or secondary source of cerebral pathology. Though severe cognitive impairments and clearer neuropathological underpinnings are more characteristic of LOD than EOD, the inconsistency of valid biomarkers remains problematic.
  • The association between Toxoplasma gondii infection and
           postpartum blues
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Jiang-Mei Gao, Zhi-Hui He, Yi-Ting Xie, Geoff Hide, De-Hua Lai, Zhao-Rong Lun Introduction and AimToxoplasma gondii is an intracellular protozoan parasite infecting approximately 30% of the global human population. It has often been suggested that chronic infection with T. gondii is related to personality changes and various mental disorders including depression. It is not known whether this includes post-partum blues or depression. In this study, we test the hypothesis that there is a relationship between T. gondii infection and post-partum blues by measuring the association between infection and postpartum blues.MethodsA total of 475 Chinese women who have just given birth were detected serology for Toxoplasma IgG and IgM antibodies, and evaluated the degree of depression by Hamilton Depression Scale (HAMD) score. Data were analyzed by Chi-square or Fisher's Exact tests using SPSS software.ResultsWe found an overall Toxoplasma seroprevalence of 5.68% (27/475; 95% CI: 3.59–7.77) which was broken down into a prevalence of 6.60% (7/106; 95% CI: 1.80–11.41) in mothers with post-partum blues and 5.42% (20/369; 95% CI: 3.10–7.74) in non-affected mothers. There was no significant association between infection and post-partum blues (p = 0.64).ConclusionThe results suggest that there is no relationship between T. gondii infection and postpartum blues, at least in this sample of patients from China.
  • Hopeful Progress but Much Research Urgently Needed
    • Abstract: Publication date: Available online 14 March 2019Source: Journal of Affective DisordersAuthor(s): A.-L. Van Harmelen, L. Schmaal, H.P. Blumberg
  • The relationship between hope and post-traumatic stress disorder in
           Chinese shidu parents: the mediating role of perceived stress
    • Abstract: Publication date: Available online 13 March 2019Source: Journal of Affective DisordersAuthor(s): Qiong Wang, Weihua Xu, Longfei Ren, Wenhao Wang, Yang Wang BackgroundParents who lost their only child and can not conceive another child, are known as shidu parents in China. This study aimed to estimate the prevalence of post-traumatic stress disorder (PTSD) and examine the mediating role of perceived stress between hope and PTSD symptoms in Chinese shidu parents.Methods295 shidu mothers and 197 shidu fathers were recruited in Shenyang city. Shidu parents were asked to complete a questionnaire including the PTSD Checklist for DSM-5 (PCL-5), the Herth Hope Index (HHI) and the Perceived Stress Scale-10 (PSS-10). Hierarchical linear regression was performed to assess the associations among hope, perceived stress and PTSD symptoms. Asymptotic and resampling strategies were used to explore the mediating role of perceived stress.ResultsThe prevalence of PTSD in Chinese shidu parents was 23.78%. Mothers were more likely to develop PTSD than fathers. For shidu fathers, the proportion of mediation of perceived stress was 39.48%. For shidu mothers, the proportion of mediation of perceived stress was 40.00%.LimitationsDue to the cross-sectional design, the findings of the present study can not be used to establish formal causal relationships or to determine the direction of causality. Longitudinal studies are need to validate our findings.ConclusionsPerceived stress partly mediated the relationship between hope and PTSD symptoms in Chinese shidu parents. The interventions of hope and perceived stress should be included in PTSD prevention. More assistance should be directed to improve the mental health of shidu mothers.
  • The effects of cognitive remediation in patients with affective psychosis:
           A systematic review
    • Abstract: Publication date: Available online 8 March 2019Source: Journal of Affective DisordersAuthor(s): Bruno Biagianti, Jaisal Merchant, Paolo Brambilla, Kathryn E Lewandowski BackgroundSchizophrenia, schizoaffective disorder, and related illnesses are associated with significant impairment in cognitive functioning which is among the strongest predictors of disability and poor quality of life. Cognitive remediation (CR) was developed as a set of behavioral interventions directly targeting cognitive symptoms. Studies have shown that CR produces cognitive improvements in patients with schizophrenia and bipolar disorder that may be associated with improvements in functioning. However, the relative efficacy of CR across diagnoses has not been established. Indirect evidence suggests that CR is effective in patients with affective illness as well as patients with schizophrenia (SZ); however, the one study to evaluate the effects of diagnosis on outcomes directly in patients with SZ versus schizoaffective disorder (SZA) found no differences by diagnosis.MethodsIn this systematic review, we evaluated cognitive and functional outcomes after CR in studies including patients with SZA, and examined specificity of training content to outcomes.ResultsSixteen studies met inclusion criteria: 10 studies that compared CR to a control condition (n = 779) and 6 comparative effectiveness studies. None of the studies explicitly compared patients by diagnosis. Studies included a mixture of patients with SZA or SZ. Of the CR versus control studies, effect sizes for cognitive outcomes were moderate-large (d = .36–.94). Studies comparing CR paradigms targeting different cognitive domains showed specificity of training focus to outcomes. Five of studies reported significant functional improvement after CR as secondary outcomes.ConclusionsIn this review, we found support for the use of CR paradigms in patients with affective psychosis, with evidence that reported treatment effects in mixed affective and non-affective samples are at or above the levels previously reported in SZ. However, lack of availability of data directly comparing patients by diagnosis or examining moderator or mediator effects of diagnosis or diagnosis-related patient characteristics limits our understanding of the relative efficacy of CR across patient group.
  • The Role of Outcome Expectancy in Therapeutic Change across Psychotherapy
           versus Pharmacotherapy for Depression
    • Abstract: Publication date: Available online 7 March 2019Source: Journal of Affective DisordersAuthor(s): Thulasi Thiruchselvam, David J.A. Dozois, R. Michael Bagby, Daniela S.S. Lobo, Lakshmi N. Ravindran, Lena C. Quilty BackgroundPatient outcome expectancy - the belief that treatment will lead to an improvement in symptoms – is linked to favourable therapeutic outcomes in major depressive disorder (MDD). The present study extends this literature by investigating the temporal dynamics of expectancy, and by exploring whether expectancy during treatment is linked to differential outcomes across treatment modalities, for both optimistic versus pessimistic expectancy.MethodsA total of 104 patients with MDD were randomized to receive either cognitive behavioral therapy (CBT) or pharmacotherapy for 16 weeks. Outcome expectancy was measured throughout treatment using the Depression Change Expectancy Scale (DCES). Depression severity was measured using both the Hamilton Depression Rating Scale and Beck Depression Inventory-II.ResultsLatent growth curve models supported improvement in expectancy across both treatments. Cross-lagged panel models revealed that both higher optimistic and lower pessimistic expectancy at mid-treatment predicted greater treatment response in pharmacotherapy. For CBT, the associative patterns between expectancy and depression differed as a function of expectancy type; higher optimistic expectancy at pre-treatment and lower pessimistic expectancy at mid-treatment predicted greater treatment response.LimitationsThe sample size limited statistical power and the complexity of models that could be explored.ConclusionsResults suggest that outcome expectancy improved during treatment for depression. Whether outcome expectancy represents a specific mechanism for the reduction of depression warrants further investigation.
  • Contextual Religiosity and The Risk of Alcohol Use Disorders and Suicidal
           Thoughts among Adults in the United States
    • Abstract: Publication date: Available online 6 March 2019Source: Journal of Affective DisordersAuthor(s): Yusuf Ransome, Ashley Perez, Shaila Strayhorn, Stephen E. Gilman, David R. Williams, Neil Krause BackgroundSuicide and alcohol use disorders (AUD) have high public health and economic costs. We investigate the relationship between religious features that are external to the individual (hereafter, contextual religiosity) and individuals’ risk of AUD and suicidal thoughts.MethodsData are from Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions (analytic N=34,326). Regression analysis assessed whether contextual (i.e., Geographic state) religiosity and membership rates of Catholics and the three major Protestant traditions, are associated with DSM-IV AUD risk in the past 12 months and suicidal thoughts since last interview, controlling for individual and state-level covariates. In a secondary analysis, we test for interactions between individual race/ethnicity and contextual religiosity on the outcomes since prior work suggested differences by race and individual religiosity.ResultsSome contextual religious variables were significantly associated with AUD risk but not suicidal thoughts. Individuals living in a state with higher membership rates of Evangelical Protestant had higher AUD risk (Adjusted Relative Risk [ARR]=1.27, 95%CI=1.08—1.49). Individuals living in states with higher membership rates of Historically Black Protestant had a lower risk of AUD (ARR=0.83, 95% CI=0.72—0.96). The interaction between individual race and contextual-level religious variables on the outcomes were not significant.LimitationsNESARC is an observational cross-sectional so causality between religiosity and the outcomes cannot be established.ConclusionsThe risk of AUD among individuals varies depending on the religious membership rates among Protestant groups within their geographic state of residence. Contextual religiosity may impact AUD risk above and beyond one's individual religiosity.
  • Subsyndromal and syndromal depressive symptoms among older adults with
           schizophrenia spectrum disorder: Prevalence and associated factors in a
           multicenter study
    • Abstract: Publication date: Available online 6 March 2019Source: Journal of Affective DisordersAuthor(s): Nicolas Hoertel, Claire Jaffré, Rachel Pascal de Raykeer, Kibby McMahon, Sarah Barrière, Yvonne Blumenstock, Christophe Portefaix, Delphine Raucher-Chéné, Céline Béra-Potelle, Christine Cuervo-Lombard, Astrid Chevance, Christophe Guerin-Langlois, Cédric Lemogne, Guillaume Airagnes, Hugo Peyre, Arthur Kaladjian, Frédéric Limosin, CSA (Cohort of individuals with Schizophrenia Aged 55 years or more) group BackgroundFew studies have examined the prevalence and correlates of subsyndromal and syndromal depressive symptoms (SSSD) among older adults with schizophrenia spectrum disorder. In this report, we examined the prevalence of SSSD and their associations with sociodemographic characteristics, clinical characteristics of schizophrenia, comorbidity, psychotropic medications, quality of life, functioning and mental health care utilization in a large, multicenter sample of older adults with schizophrenia spectrum disorder.MethodsData from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) were used to examine the prevalence of SSSD, defined using the Center of Epidemiologic Studies Depression (CESD) scale. Clinical characteristics associated with SSSD were explored.Results: Among 343 older adults with schizophrenia spectrum disorder, 78.1% had either subsyndromal (30.6%) or syndromal (47.5%) depressive symptoms. SSSD were independently associated with positive and negative symptoms, lower quality of life, non-late-onset psychosis, benzodiazepine use and urbanicity. There were no significant associations of SSSD with other sociodemographic characteristics and psychotropic medications, or with general medical conditions. We found no significant differences in the proportion of participants who were treated with antidepressants between those with syndromal depressive symptoms and those without depression (22.1% vs. 20.0%, p=0.89). SSSD were not associated with higher mental health care utilization.LimitationsData were cross-sectional and depression was not evaluated with a semi-structured interview.Conclusion: SSSD may be highly prevalent and under-assessed and/or undertreated among older adults with schizophrenia spectrum disorder. Our findings should alert clinicians about the need to assess systematically and regularly depression in this vulnerable population.
  • Cognitive Behavioural Therapy for Childhood Anxiety Disorders: What
           Happens to Comorbid Mood and Behavioural Disorders' A Systematic
    • Abstract: Publication date: Available online 6 March 2019Source: Journal of Affective DisordersAuthor(s): Mishka Mahdi, Sanjana Jhawar, Sophie Bennett, Roz Shafran BackgroundHigh rates of comorbidity among children and adolescents with anxiety disorders are widely documented. To date the question of what happens to comorbid disorders upon treatment of the primary anxiety disorder has received little attention and the optimal treatment strategy for cases with comorbidity remains to be determined.ObjectivesThis review examines the literature on the impact of disorder-specific CBT on comorbid mood and behavioural disorders in young people with a primary anxiety disorder.Search MethodsPsycINFO, EMBASE, MEDLINE and the Cochrane Library were systematically searched using predefined selection criteria. Two reviewers independently assessed the relevance of studies, obtained data using a data extraction form and undertook methodological quality analysis.ResultsTen studies (1,647 children in total) were included in the review. All studies demonstrated positive outcomes for CBT focused on the primary anxiety disorder on untargeted comorbid mood and/or externalising disorders.ConclusionsFindings suggest CBT focused on the primary anxiety disorder successfully reduces comorbid mood and/or behavioural diagnoses and symptoms of these co-occurring clinical diagnoses. Therefore, the implementation of disorder-specific CBT for the primary disorder is a valid alternative to transdiagnostic interventions and is recommended in cases of comorbidity in children and adolescents with a primary anxiety disorder.
  • Allergies, asthma, and psychopathology in a nationally-representative US
    • Abstract: Publication date: Available online 6 March 2019Source: Journal of Affective DisordersAuthor(s): Kristen Kelly, Scott Ratliff, Briana Mezuk BackgroundSymptoms of mood and anxiety have been associated with immune dysregulation and atopic disorders, however it is unclear whether this relationship spans other forms of psychopathology. The objective of this study was to use a large, population-based sample to examine the association between several common psychiatric conditions and two atopic disorders: seasonal allergies and asthma. This study also examined whether comorbidity between psychiatric disorders confounded the relationship between atopy and each psychiatric disorder.MethodsData come from the Comprehensive Psychiatric Epidemiology Surveys, a nationally-representative sample of US adults (N=10,309). Lifetime history of Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Panic Disorder (PD), and Post-Traumatic Stress Disorder (PTSD) was assessed using the Composite International Diagnostic Inventory. History of seasonal allergies and asthma were assessed by self-report. Weighted logistic regression was used to evaluate the association between allergies and asthma and psychopathology. Psychiatric comorbidities were also examined as potential confounders.ResultsApproximately 36.6% had a history of allergies and 11.5% a history of asthma. Seasonal allergies were positively associated with odds of MDD (Odds ratio (OR): 1.24, 95% Confidence Interval (CI): 1.06-1.46), GAD (OR: 1.54 (1.28-1.84)), PD (OR: 1.53 (1.24-1.91)), and PTSD (OR: 1.32 (1.09-1.59)). Asthma was not significantly associated with any psychiatric disorder. All significant associations persisted after adjustment for psychiatric comorbidities.LimitationsLimitations include self-reporting of atopic disorder status and of all disorder ages of onset.ConclusionsThis study confirms the association between MDD and PD and seasonal allergies, and extends this relationship to GAD and PTSD.
  • Points that need attention in quantitative EEG gamma synchronization
    • Abstract: Publication date: Available online 23 February 2019Source: Journal of Affective DisordersAuthor(s): Yi-Ting Lin, Hong-Hsiang Liu, Ming H. Hsieh
  • Re: Jing et al., the efficacy of cognitive behavioural therapy in
           somatoform disorders and medically unexplained physical symptoms: A
           meta-analysis of randomized controlled trials
    • Abstract: Publication date: Available online 19 February 2019Source: Journal of Affective DisordersAuthor(s): Allan Abbass, Falk Leichsenring, Christiane Steinert
  • Corrigendum to ``Changing of suicide rates in China, 2002–2015''
           [Journal of affective disorders 240 (2018) 165–170]
    • Abstract: Publication date: Available online 8 February 2019Source: Journal of Affective DisordersAuthor(s): Hui Jiang, Lu Niu, Jessica Hahne, Mi Hu, Jing Fang, Minxue Shen, Shuiyuan Xiao
  • Corrigendum to “Identifying cognitive subgroups in bipolar disorder: A
           cluster analysis” [Journal of Affective Disorders 246C (2019) 252–261]
    • Abstract: Publication date: Available online 8 February 2019Source: Journal of Affective DisordersAuthor(s): Flávia Lima, Francisco Diego Rabelo-da Ponte, Joana Bücker, Letícia Czepielewski, Mathias Hasse-Sousa, Raissa Telesca, Brisa Solé, Maria Reinares, Eduard Vieta, Adriane R. Rosa
  • Corrigendum to “Comparison of comorbid depression between irritable
           bowel syndrome and inflammatory bowel disease: A meta-analysis of
           comparative studies” [J Affect Disord. 2018 237: 37–46. doi:
    • Abstract: Publication date: Available online 15 January 2019Source: Journal of Affective DisordersAuthor(s): Qin Geng, Qing-E Zhang, Fei Wang, Wei Zheng, Chee H. Ng, Gabor S. Ungvari, Gang Wang, Yu-Tao Xiang
  • Repetitive transcranial magnetic stimulation for depression: The
           non-inferiority extrapolation
    • Abstract: Publication date: Available online 5 January 2019Source: Journal of Affective DisordersAuthor(s): Ali Amad, Florian Naudet, Thomas Fovet
  • Psychiatry: A discipline at specific risk of mental health issues'
    • Abstract: Publication date: Available online 26 December 2018Source: Journal of Affective DisordersAuthor(s): Patrick Hardy, Isabelle Devouge, Antoine Pelissolo, Emmanuelle Corruble
  • Methemoglobinemia as a biomarker of dapsone-induced mania severity
    • Abstract: Publication date: Available online 25 December 2018Source: Journal of Affective DisordersAuthor(s): Romain Colle, Abd El Kader Ait Tayeb, Pierre Mesdom, Mathilde de Menthon, Laurent Becquemont, Céline Verstuyft, Denis J. David, Olivier Lambotte, Emmanuelle Corruble BackgroundThe underlying mechanism involved in dapsone-induced mania remains unknown.MethodsWe report the case of a 54-year-old man with a dapsone-induced mania.ResultsThe maximum of manic symptoms was correlated with the maximum of methemoglobinemia and mania decreased concomitantly with the methemoglobinemia level.LimitationsThis is a single case.ConclusionsThis case shows that dapsone-induced mania severity is correlated with methemoglobinemia level, leading for the first time to the hypothesis of a physiopathological mechanism by which dapsone could induce mania.
  • Effectiveness of group interpersonal psychotherapy for decreasing
           aggression and increasing social support among Chinese university
           students: A randomized controlled study
    • Abstract: Publication date: Available online 18 December 2018Source: Journal of Affective DisordersAuthor(s): Yutong Li, Nor Aniza binti Ahmad, Zoharah binti Omar, Linyu Zhang, Samsilah bt Roslan BackgroundThe objective of this randomized controlled experimental study was to determine the intervention effect of group interpersonal psychotherapy (G-IPT) for aggression and social support among Chinese first-grade university students.MethodsThrough stratified random sampling, 1469 students, aged 18–19 years, were enrolled. Participants whose score achieved the aggressive evaluation standard were selected and then 60 participants were randomly divided into 2 groups: G-IPT and control. The participants in the G-IPT group received 16 sessions of treatment, whereas the participants in the control group did not receive any intervention. All participants completed the assessment three times: before, after, and tracking.ResultsThe results showed that the total score and the scores of all subscales of aggression dropped significantly (P < 0.01). Also, the total score and the scores of objective support and utilization degree of social support increased significantly (P < 0.05).ConclusionG-IPT was effective in treating aggression and improving social support level, and the effect was stable.
  • Corrigendum to prenatal maternal anxiety and children's brain structure
           and function: A systematic review of neuroimaging studies
    • Abstract: Publication date: Available online 15 December 2018Source: Journal of Affective DisordersAuthor(s): Brianna Adamson, Nicole Letourneau, Catherine Lebel
  • Role of palmitoylethanolamide (PEA) in depression: Translational evidence
    • Abstract: Publication date: Available online 25 October 2018Source: Journal of Affective DisordersAuthor(s): Danilo De Gregorio, Mirko Manchia, Bernardo Carpiniello, Flavia Valtorta, Maria Nobile, Gabriella Gobbi, Stefano Comai BackgroundAntidepressants have a low rate of response paired with a delayed onset of action. Translational studies are thus seeking for novel targets for antidepressant drug development. Preclinical evidence has demonstrated that the endocannabinoid system plays an important role in mood and stress response, even if drugs targeting this system have not yet become available for clinical use. The dietary supplement N-Palmitoylethanolamide (PEA) is a fatty acid amide belonging to the endocannabinoid system with potential antidepressant properties.MethodsWe performed a bibliographic search to review current knowledge on the potential antidepressant effects of PEA and its underlying mechanism of action.ResultsPEA targets not only the peroxisome proliferator-activated receptor-alpha (PPAR-α), but also the endocannabinoid system, binding the G-protein-coupled receptor 55, a non-CB1/CB2 cannabinoid receptor, and also the CB1/CB2 receptors, although with a weak affinity. Preclinical studies have shown antidepressant activity of PEA in animal paradigms of depression and of depression associated with neuropathic pain and traumatic brain injury. In a translational perspective, PEA is increased in stress conditions, and a randomized, double-blind study in depressed patients indicated a fast-antidepressant action of PEA when associated with citalopram.LimitationsThere are still limited preclinical and clinical studies investigating the effect of PEA upon the endocannabinoid system and its potential as antidepressant.ConclusionsPEA has potential antidepressant effects alone or in combinations with other classes of antidepressants. Future studies in depressed patients are needed to confirm the mood-modulating properties of PEA and its role as a biomarker of depression.
  • The impact of binge eating behavior on lithium- and quetiapine-associated
           changes in body weight, body mass index, and waist circumference during 6
           months of treatment: Findings from the bipolar CHOICE study
    • Abstract: Publication date: Available online 12 September 2018Source: Journal of Affective DisordersAuthor(s): Satyanarayana R. Yaramala, Susan L. McElroy, Jennifer Geske, Stacey Winham, Keming Gao, Noreen A. Reilly-Harrington, Terence A. Ketter, Thilo Deckersbach, Gustavo Kinrys, Masoud Kamali, Louisa G. Sylvia, Melvin G. McInnis, Edward S. Friedman, Machael E. Thase, James H. Kocsis, Mauricio Tohen, Joseph R. Calabrese, Charles L. Bowden, Richard C. Shelton, Andrew A. NierenbergABSTRACTBackgroundLithium and quetiapine can cause weight gain, but their comparative longer term anthropometric effects are unknown, as are the potential moderating effects of baseline binge-eating (BE) behavior.MethodsWe assessed 6 month changes in body weight, body mass index (BMI) and waist circumference in 482 adults with DSM-IV bipolar disorders who participated in a comparative effectiveness study of lithium and quetiapine with evidence-based adjunctive treatment (Bipolar CHOICE). Anthropometric measurements were obtained at baseline, and at 2, 4, 6, 8, 12, 16, 20, and 24 weeks. BE behavior was defined as affirmative responses to MINI items M1 and M3 at baseline. Data were analyzed using a mixed model repeated measures approach, adjusted for baseline values of dependent measures.ResultsOn average, body weight and BMI increased over 6 months with lithium and quetiapine. However, those treated with quetiapine experienced greater increases from baseline in body weight (peak change, + 3.6 lbs. vs. + 1.4 lbs.) and BMI (peak change, + 0.6 kg/m2 vs. + 0.3 kg/m2), starting at 2 weeks (group x time, F8,3052 = 2.9, p = 0.003 for body weight, F8,3052 = 3.0, p = 0.002 for BMI). Significant increases in waist circumference were observed only with quetiapine. The relationship between drug treatment and changes in body weight (group x time x binge eating status, F1,2770 = 2.0, p = 0.002), BMI (F1,2767 = 2.0, p = 0.002), and waist circumference (women only, F25,1621 = 2.9, p 
  • Corrigendum to “Lithium, Stress, and Resilience in Bipolar Disorder:
           Deciphering this key homeostatic synaptic plasticity regulator.” [J
           Affect Disord. 2018;233:92–99].
    • Abstract: Publication date: Available online 1 September 2018Source: Journal of Affective DisordersAuthor(s): Rodrigo Machado-Vieira
  • The utility of PHQ-9 and CGI-S in measurement-based care for predicting
           suicidal ideation and behaviors
    • Abstract: Publication date: Available online 15 June 2018Source: Journal of Affective DisordersAuthor(s): Kara Glazer, Kelly Rootes-Murdy, Michael Van Wert, Francis Mondimore, Peter Zandi BackgroundMeasurement-based care (MBC) has emerged as an effective strategy for improving outcomes in patients with mood disorders. Suicide is a particularly devastating outcome of mood disorders. Using data from a new MBC program from the National Network of Depression Centers (NNDC), we examined whether capturing a patient-rated symptom measure, the patient health questionnaire (PHQ-9), along with a provider-rated global functioning measure, the clinical global impression scale (CGI-S), improves identification of patients at risk of suicide over using either measure alone.MethodsA total of 126 adults with mood disorders from nine sites in the NNDC completed the PHQ-9 and CGI-S and had at least one subsequent visit where they completed the Columbia-suicide severity rating scale (C-SSRS). The PHQ-9 (≥10) and CGI-S (≥4) were dichotomized at commonly accepted severity thresholds. Associations of the PHQ-9 and CGI-S with suicidal ideation or behavior were examined using Firth's logistic regression to accommodate small samples while controlling for age, sex, race, and diagnosis.ResultsPatients who scored higher on only the PHQ-9 or CGI-S were not significantly more likely to experience subsequent suicidal ideation or behaviors. However, patients who scored higher on both the PHQ-9 and CGI-S were significantly more likely to experience suicidal ideation (OR = 4.70, p = 0.0005) and suicidal behaviors (OR = 25.38, p = 0.0003).DiscussionInformation from both patient and clinician-rated measures was better able to identify patients with mood disorders at risk for suicidal ideation and behaviors. Using both together may help reduce the risk of suicide by identifying those patients at greatest risk and allowing for more targeted interventions.
  • Influence of clinical features on cognition in bipolar disorder: Comment
           on the meta-analysis published by Bora (2018)
    • Abstract: Publication date: Available online 31 March 2018Source: Journal of Affective DisordersAuthor(s): Charles Cotrena, Laura Damiani Branco
  • Resting-state mapping of neural signatures of vulnerability to depression
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Chun-Hong Liu, Li-Rong Tang, Yue Gao, Guang-Zhong Zhang, Bin Li, Meng Li, Marie Woelfer, Walter Martin, Lihong Wang BackgroundPatients with major depressive disorder (MDD) can frequently develop new depressive episodes after remission. However, the neural mechanisms underlying the increased risk for depressive relapse remain unclear. Herein, we aimed to explore whether the specific changes to regional and inter-regional spontaneous brain activities within DMN are associated with the course of episodes in pooled MDD patients.MethodsResting-state functional magnetic resonance imaging was performed on patients with single-episode MDD (SEMDD, n = 30) and multiple-episode MDD (MEMDD, n = 54), and 71 age-, gender-, and educational level-matched healthy controls (HCs). We then accessed the differences in both the fractional amplitude of low-frequency fluctuations (fALFF) and functional connectivity by using the right precuneus as the seed among different groups.ResultsCompared to the MEMDD and HC groups, the SEMDD group exhibited increased fALFF values in the right subgenual anterior cingulate cortex and right middle temporal gyrus. Decreased fALFF values in the right thalamus in the MEMDD group were also identified relative to the SEMDD and HC group. The peak values of fALFF in the right precuneus showed a negative correlation with the number of depressive episodes across the entire pool of MDD patients. No correlation was identified between functional connectivity using the right precuneus as the seed and the number of depressive episodes for the pooled MDD patients.LimitationsMedication, a relatively small sample size, and hypothesis driven study.ConclusionsOur neuroimaging results identified depression relapse-associated neural signatures and also indicated the role of reduced emotional appraisals in the thalamus. It is now possible to believe that the regional activity not inter-regional connectivity within the DMN may be involved in the pathology of depression relapse.
  • The relationship of dispositional compassion for others with depressive
           symptoms over a 15-year prospective follow-up
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Aino Saarinen, Liisa Keltikangas-Järvinen, C. Robert Cloninger, Juha Veijola, Marko Elovainio, Terho Lehtimäki, Olli Raitakari, Mirka Hintsanen Background: The aim of this study was to investigate (i) the direction of the relationships between dispositional compassion for others and depressive symptoms over a 15-year follow-up in adulthood and (ii) the longitudinal associations of dispositional compassion with total depressive symptoms and various depressive subsymptoms (i.e. negative attitude, performance difficulties, and somatic complaints) from early adulthood to middle age.Methods: The participants (N = 1676) came from the prospective Young Finns Study. Dispositional compassion was assessed with the Temperament and Character Inventory and depressive symptoms with a modified version of the Beck Depression Inventory. The measurements were conducted between 1997−2012 including three measurement points. The data was analyzed using structural equation models and multilevel models for longitudinal design.Results: The predictive relationships were more likely to proceed from high dispositional compassion for others to lower depressive symptoms than in the opposite direction. Additionally, high dispositional compassion predicted a lower total score of depressive symptoms and also lower scores of various depressive subsymptoms (negative attitude, performance difficulties, somatic complaints) in early adulthood. These associations, however, weakened over years and became non-significant in middle age. All the findings were sustained after controlling for age, gender, and socioeconomic factors in childhood and adulthood.Limitations: Depressive symptoms were mostly mild and non-clinical in our sample. The findings cannot be directly generalized to severe depressive symptomatology.Conclusions: When tailoring psychiatric interventions, it is necessary to be aware that compassion for others may lower the risk for the onset and maintenance of depressive symptoms, especially in early adulthood.
  • Association between citalopram, escitalopram and QTc prolongation in a
           real-world geriatric setting
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Gabrielle Crépeau-Gendron, Hilary K. Brown, Carrie Shorey, Robert Madan, Claudia Szabuniewicz, Samantha Koh, Shelley Veinish, Linda Mah BackgroundAlthough the US Food and Drug Administration (FDA) recommended upper limits for citalopram dosing in older adults due to risk of corrected-QT (QTc) prolongation, which was adopted, and extended to escitalopram by Health Canada, the scientific basis is unclear. The objective of this study was to assess the relationship between citalopram/escitalopram dosages and QTc interval in a real-world geriatric setting.MethodsWe reviewed electronic health records at a university-affiliated geriatric health care center, over a 7-year period, to identify patients prescribed citalopram and escitalopram, who had an ECG within 90 days of initiation or dosage change. Linear regression analyses were conducted to assess the relationship between antidepressant dosage and QTc interval.Results137 patients were identified (citalopram=97, escitalopram=40). No association was found between citalopram, escitalopram and QTc, in unadjusted or adjusted analyses. Among covariates, older age was significantly associated with QTc prolongation in the escitalopram group.LimitationsLimitations to the current study include its retrospective design and the small sample size.ConclusionsThese data do not support the FDA or Health Canada's recommended maximum dosages of citalopram or escitalopram in the elderly. Therefore, for patients already on higher doses of these medications, the risk of QTc prolongation may not always outweigh the risk of dose lowering, such as relapse. Until larger prospective studies become available, the decision to comply or not with these federal agencies’ recommendations should be weighed on an individual basis, taking into consideration all potential risk factors.
  • Differentiating acute suicidal affective disturbance (ASAD) from anxiety
           and depression Symptoms: A network analysis
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Megan L. Rogers, Melanie A. Hom, Thomas E. Joiner BackgroundA growing body of literature supports the potential existence of a new clinical entity, Acute suicidal affective disturbance (ASAD), which is characterized by rapid-onset, acute suicidality. This study aimed to evaluate whether current ASAD symptoms (i.e., suicidal intent, thwarted belongingness, perceived burdensomeness, disgust with others and oneself, agitation, irritability, insomnia, and nightmares) comprise a psychopathological network distinct from anxiety and depression symptoms.MethodsA sample of 167 psychiatric inpatients completed self-report measures of current ASAD, anxiety, and depression symptoms.ResultsNetwork analyses revealed three distinct clusters of symptoms corresponding to ASAD, anxiety, and depression symptom self-report measure items. Namely, ASAD symptoms not only demonstrated strong associations with each other, but they also exhibited weak associations with symptoms of anxiety and depression.LimitationsThis study utilized a cross-sectional design and distinct self-report measures to assess all constructs, which may have led to methodological confounds that influenced the observed network structure.ConclusionsOverall, our findings provide further evidence for ASAD as a syndrome with strongly interrelated symptoms. Furthermore, results indicate that ASAD may represent a construct distinct from anxiety and depression, underscoring its potential diagnostic value. Additional research is needed to replicate these findings across other high-risk populations, as well as to examine how ASAD symptoms may relate to other psychiatric symptoms.
  • Aripiprazole for the treatment of duloxetine-induced hyperprolactinemia: A
           case report
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Tao Luo, Qiao-sheng Liu, Yuan-jian Yang, Bo Wei BackgroundIt is well known that aripiprazole co-treatment effectively reduces antipsychotic-induced hyperprolactinemia. However, the effectiveness of aripiprazole to treat high prolactin levels induced by antidepressant drugs with serotoninergic activity, such as duloxetine, remains unknown.Case presentationAn 18-year-old female diagnosed with major depressive disorder (MDD) was treated with 100 mg sertraline once daily. After two weeks, galactorrhoea was observed. Blood biochemical tests revealed an elevated serum prolactin level of 241 ng/mL. Physiological causes and additional potential pathological causes were ruled out. Therefore, sertraline was cross tapered with mirtazapine. Galactorrhoea ceased, but the side-effect of sedation prompted a switch to 40 mg duloxetine twice daily. After two weeks, the patient developed menstrual irregularities and milky discharge concomitant with a serum prolactin level of 205 ng/mL. As a result, duloxetine was decreased to 60 mg once daily, and aripiprazole was initiated at 2.5 mg daily and titrated to 5 mg daily. Two weeks after the initiation of dual therapy, galactorrhoea stopped, and prolactin levels decreased to 118 ng/mL. After eight weeks, prolactin levels decreased to 39 ng/mL, and menstruation returned to normal. After antidepressant therapy finished, prolactin levels normalized to 19 ng/mL.ConclusionThe case suggests that adjunctive aripiprazole may be useful as a treatment option for duloxetine-induced hyperprolactinemia in MDD.
  • Suicidal ideation and behavior in Huntington's disease: Systematic review
           and recommendations
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Zachary R. Kachian, Shira Cohen-Zimerman, Danny Bega, Barry Gordon, Jordan Grafman BackgroundAn increased risk of suicide in Huntington's disease (HD) patients is well documented, with rates significantly higher than those of the general population as well as other neurodegenerative diseases. However, despite its prevalence, the magnitude of this phenomenon as well as its predictors and etiology are still poorly understood.MethodsWe performed the first systematic review of all the studies published between March 1993 and December 2018 which investigated HD patients and gene carriers that reported suicidal ideation, suicide attempt, or suicide as an outcome.ResultsThis review reveals that some aspects of suicidality in HD are more clearly understood than others. We confirm an increased risk of suicidal ideation, suicide attempt, and suicide for HD patients. We found that suicidal ideation is elevated throughout the course of the disease, and that psychiatric comorbidities are common risk factors with depression being the most prominent.LimitationsImportant data are still largely missing, specifically regarding cognitive and neuroanatomical mechanisms and potential effective interventions. Moreover, inconsistencies in terminology, assessment tools, and outcome measures limit the comparability of the research and the conclusions that can be drawn.ConclusionsIncidence of suicidal ideation, suicide attempt, and suicide are higher among those with HD relative to the non-HD population. It is therefore important that suicidal thoughts and behaviors are closely monitored in HD clinics and that clinical trials use standardized scales. Future research should focus on better understanding the etiology of this high suicide risk and on testing the efficacy of potential interventions.
  • Acupuncture treatment is associated with a decreased risk of developing
           stroke in patients with depression: A propensity-score matched cohort
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Liang-Yu Chen, Hung-Rong Yen, Mao-Feng Sun, Cheng-Li Lin, Jen-Huai Chiang, Yu-Chen Lee BackgroundDepression had a significantly increased risk of stroke. Some patients with depression seek acupuncture treatment. The aim of this study is to investigate the association between acupuncture treatment and risk of developing stroke in patients with depression.MethodsPatients with newly diagnosed depression above 18 years old between 1997 and 2010 were selected from the Taiwanese National Health Insurance Research Database, and followed up until the end of 2013. The 1:1 propensity score method was used to match an equal number of patients (N = 13,823) in the acupuncture and non-acupuncture cohorts, based on characteristics including sex, age, baseline comorbidity and drug used. The outcome measurement was the comparison of stroke incidence in the two cohorts. We used the Cox regression model and the Kaplan–Meier method to estimate the risk of developing stroke.ResultsCompared with the non-acupuncture cohort, patients who received acupuncture treatment had a lower risk of stroke (adjusted hazard ratio (HR) = 0.49, 95% confidential interval = 0.45–0.52) after adjustment for age, sex, comorbidities and drugs used. Regarding the two types of stroke, acupuncture users also had lower risk of hemorrhagic or ischemic stroke (adjusted HR = 0.37 and 0.49, respectively). The cumulative incidence of stroke in the acupuncture cohort was significantly lower than that of the non-acupuncture cohort (log-rank test, p 
  • Pilot study of a lifestyle intervention for bipolar disorder: Nutrition
           exercise wellness treatment (NEW Tx)
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Louisa G. Sylvia, Samantha L. Pegg, Steven C. Dufour, Jessica A. Janos, Emily E. Bernstein, Weilynn C. Chang, Nathan E. Hall, Kristen K. Ellard, Andrew A. Nierenberg, Thilo Deckersbach BackgroundIndividuals with bipolar disorder (BD) are more likely than the general population to develop risk factors associated with cardiovascular disease, one of the leading causes of morbidity and mortality in this clinical population. To address this disproportionate medical burden, we developed Nutrition Exercise and Wellness Treatment (NEW Tx), a lifestyle intervention for individuals with BD.MethodsIn this study, participants were randomized to NEW Tx (n = 19) or a treatment as usual waitlist (n = 19). We examine the intervention's efficacy to improve the physical and psychological outcomes of individuals with BD. Assessors were blind to participant condition throughout study duration.ResultsThe NEW Tx group reported increased weekly exercise duration and overall functioning, and decreased depression and illness severity over the study duration. However, only improvements in functioning were significantly greater in the NEW Tx group than in the control group. There were no group differences in weight loss or mood symptoms over the study duration.LimitationsLimitations to this study include lack of objective measurement of exercise and a small and relatively homogeneous sample.ConclusionsThese data suggest that a manualized lifestyle intervention for BD may not be ideal to improve lifestyle changes in this clinical population. Further research is needed to pilot personalized approaches to creating a healthy lifestyle in BD.
  • Increased brain entropy of resting-state fMRI mediates the relationship
           between depression severity and mental health-related quality of life in
           late-life depressed elderly
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Chemin Lin, Shwu-Hua Lee, Chih-Mao Huang, Guan-Yen Chen, Pei-Shan Ho, Ho-Ling Liu, Yao-Liang Chen, Tatia Mei-Chun Lee, Shun-Chi Wu BackgroundEntropy analysis is a computational method used to quantify the complexity in a system, and loss of brain complexity is hypothesized to be related to mental disorders. Here, we applied entropy analysis to the resting-state functional magnetic resonance imaging (rs-fMRI) signal in subjects with late-life depression (LLD), an illness combined with emotion dysregulation and aging effect.MethodsA total of 35 unremitted depressed elderly and 22 control subjects were recruited. Multiscale entropy (MSE) analysis was performed in the entire brain, 90 automated anatomical labeling-parcellated ROIs, and five resting networks in each study participant.LimitationsDue to ethical concerns, all the participants were under medication during the study.ResultsRegionally, subjects with LLD showed decreased entropy only in the right posterior cingulate gyrus but had universally increased entropy in affective processing (putamen and thalamus), sensory, motor, and temporal nodes across different time scales. We also found higher entropy in the left frontoparietal network (FPN), which partially mediated the negative correlation between depression severity and mental components of the quality of life, reflecting the possible neural compensation during depression treatment.ConclusionMSE provides a novel and complementary approach in rs-fMRI analysis. The temporal-spatial complexity in the resting brain may provide the adaptive variability beneficial for the elderly with depression.
  • The role of hormonal, metabolic and inflammatory biomarkers on sleep and
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Mariarita Caroleo, Elvira Anna Carbone, Amedeo Primerano, Daniela Foti, Antonio Brunetti, Cristina Segura-Garcia BackgroundMajor depressive disorder (MDD) is a complex and heterogeneous disorder in which clinical symptoms can widely differ among patients. Neurovegetative symptoms, i.e. decreased or increased appetite, changes in body weight and sleep disturbances, described as 'melancholic’ or ‘atypical’ features of a depressive episode, are the most variable symptoms among patients with MDD. We hypothesized biomarkers differences underlying this neurovegetative variability in major depression.MethodsWe systematically reviewed, according to the PRISMA guidelines, the role of specific metabolic, hormonal and inflammatory biomarkers in drug-free MDD patients, that could have neurobiological effects on appetite, weight regulation and circadian rhythms, influencing eating behaviour and sleep patterns. All studies regarding the co-occurrence of disturbed sleep and appetite were examined.ResultsBesides the well-known leptin and ghrelin, other biomarkers such as BDNF, VEGF, NPY, orexin, and the recent discovered nesfatin-1 seem to be involved in neurovegetative changes in depressive disorders playing a role in the regulation of affective states, stress reactions and sleep patterns. Interestingly, based on the existing evidence, ghrelin, orexin and nesfatin-1 could be linked both to sleep and appetite regulation in depressed patients.LimitationsHeterogeneous studies with low sample size.ConclusionsDespite the wide heterogeneity of results, studies on biomarkers of appetite and sleep in MDD are an interesting field of research to explain the neurobiological substrates of depressive symptoms that deserve further investigation.
  • Children's appraisals of maternal depression and responses to emotional
           faces in early-adolescence: An Event Related Potential (ERP) study
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Arin M. Connell, Sarah Danzo, Kelsey Magee, Rana Uhlman BackgroundParental depression represents a significant risk for depression development in offspring. While cognitive mechanisms represent a central risk pathway, children's appraisals of parental symptoms have been understudied. This study examined associations between children's self-blame, threat, and frequency/duration appraisals for maternal symptoms in relation to cognitive control and emotional response processes.MethodsSixty mother-daughter (aged 10–14-years) pairs participated. Affective processing was assessed by three Event Related Potential (ERP) components, the N2, P3, and LPP, during an emotional Go/NoGo task.ResultsThreat-appraisals were associated with alterations in all three ERP components, independently of maternal diagnostic histories or youth depressive symptoms. Self-blame was associated with early attentional engagement towards calm faces. Independent effects of maternal depression history and youth symptoms were also observed.ConclusionsResults highlight the importance of youth perceptions of maternal depressive symptoms in models of depression-risk.
  • How to modify persisting negative expectations in major depression' An
           experimental study comparing three strategies to inhibit cognitive
           immunization against novel positive experiences
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Tobias Kube, Julia Anna Glombiewski, Jeremias Gall, Leslie Touissant, Thomas Gärtner, Winfried Rief Background:Research has shown that negative expectations in major depressive disorder (MDD) often persist despite positive disconfirming experiences. To explain this phenomenon, the concept of cognitive immunization has been introduced: that is, individuals with MDD reappraise disconfirming positive evidence in such a way that negative expectations are maintained. In this study, we examined whether it is possible to inhibit cognitive immunization to facilitate expectation update.Methods:We examined 113 people with MDD being treated in an inpatient psychosomatic hospital. Using a previously validated paradigm, participants worked on a standardized performance test; we examined changes in negative performance-related expectations after positive expectation-disconfirming feedback. One experimental group received additional information increasing the value of the positive feedback (‘INFORMATION’). Another group was instructed to recall the feedback after completing the task (‘RECALL’). In a third group, participants’ attention was shifted to potential expectation-disconfirming feedback (‘ATTENTION’). In addition, a control group underwent the standard procedure of the paradigm.Results:The results showed significant group differences in the change in generalized performance expectations, with the largest changes in participants from the INFORMATION group. All experimental groups had lower values for cognitive immunization than the control group.Limitations:Given that this proof-of-concept study was the first to examine strategies to inhibit cognitive immunization, the findings need to be replicated in future studies.Conclusions:The present study confirms that cognitive immunization in MDD can be inhibited, thus facilitating adjusting negative expectations. The most promising results were found for the INFORMATION group, providing information to emphasize the relevance of expectation-disconfirming information.
  • Inaccuracy between subjective reports and objective measures of sleep
           duration and clinical correlates in bipolar disorder
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Christopher N. Kaufmann, Marina Z. Nakhla, Ellen E. Lee, Ho-Kyoung Yoon, David Wing, Colin A. Depp, Lisa T. Eyler BackgroundSleep disturbances are common in bipolar disorder (BD) and are often assessed by self-report at clinic visits over the course of BD treatment. Self-report may be subject to recall bias based upon current mood/affect states. This study sought to identify the degree of inaccuracy between subjective and objective measures of sleep duration in those with and without BD, and to assess the demographic and clinical correlates of this inaccuracy.MethodsThirty-one individuals with BD and 54 healthy control (HC) participants reported on the number of hours slept a night over the past month and subsequently completed up to 14 days/nights of wrist actigraphy which provided an objective measure of sleep duration. We compared the subjective rating to the average of all nights of objective sleep duration, and correlated the magnitude of inaccuracy with demographic and clinical characteristics in the BD and HC groups.ResultsOn average, both BD and HC groups overestimated their sleep, and there were no differences in inaccuracy between groups. In the BD group, greater inaccuracy was associated with lower functioning, even after controlling individually for objective and subjective sleep measures.LimitationsCross-sectional study, only focus on sleep duration, and less severe bipolar symptoms of sample.ConclusionsInaccuracy in reports of sleep duration was associated with lower functioning among BD patients. Better identifying discrepancies in reports of sleep duration in clinical practice could help in more efficient monitoring and management of BD symptoms.
  • Biological and psychosocial predictors of anxiety worsening in the
           postpartum period: A longitudinal study
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Melissa Furtado, Ryan J. Van Lieshout, Michael Van Ameringen, Sheryl M. Green, Benicio N. Frey BackgroundAs many as 20% of women will experience an anxiety disorder during the perinatal period. Women with pre-existing anxiety disorders are at increased risk of worsening during this time, yet little is known about its predictors.Study AimTo investigate the psychosocial and biological risk factors for anxiety worsening in the postpartum in women with pre-existing anxiety disorders.MethodsThirty-five (n = 35) pregnant women with pre-existing DSM-5 anxiety disorders were enrolled in this prospective study investigating the psychosocial (e.g., childhood trauma, intolerance of uncertainty, depression) and biological risk factors (e.g. C-reactive protein, interleukin-6, tumor necrosis factor-α) for anxiety worsening in the postpartum period. Anxiety worsening was defined as an increase of ≥50% or greater on Hamilton Anxiety Rating Scale scores from the third trimester of pregnancy (32.94 ± 3.35 weeks) to six weeks postpartum.ResultsIntolerance of uncertainty, depressive symptom severity, and obsessive-compulsive disorder symptoms present in pregnancy were significant predictors of anxiety worsening in the postpartum.LimitationsSample heterogeneity and limited sample size may affect study generalizability.ConclusionsTo our knowledge, this is the first longitudinal study to investigate psychosocial and biological risk factors for anxiety worsening in the postpartum in women with pre-existing anxiety disorders. Continued research investigating these risk factors is needed to elucidate whether they differ from women experiencing new-onset anxiety disorders in the perinatal period, and those in non-puerperal groups. Identifying these risk factors can guide the development of screening measures for early and accurate symptom detection. This can lead to the implementation of appropriate interventions aimed at decreasing the risk of perinatal anxiety worsening.
  • Pilot randomized controlled trial of a Spanish-language Behavioral
           Activation mobile app (¡Aptívate!) for the treatment of depressive
           symptoms among united states Latinx adults with limited English
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Jennifer Dahne, Anahi Collado, C.W. Lejuez, Cristina M. Risco, Vanessa A. Diaz, Lisa Coles, Jacob Kustanowitz, Michael J. Zvolensky, Matthew J. Carpenter BackgroundTo address the need for disseminable, evidence-based depression treatment options for Latinx adults with limited English proficiency (LEP), our team developed ¡Aptívate!, a Spanish-language Behavioral Activation self-help mobile application. Primary aims of this study were to: 1) examine feasibility and uptake of ¡Aptívate! among depressed Latinx adults with LEP and 2) preliminarily examine ¡Aptívate! efficacy for depression treatment.MethodsParticipants (N = 42) with elevated depressive symptoms were randomized 2:1:1 to: 1) ¡Aptívate! (n = 22), 2) an active control Spanish-language app (“iCouch CBT”; n = 9), or 3) Treatment As Usual (i.e., no app; n = 11). Feasibility was assessed via self-reported app utilization and app analytics data. Depressive symptoms were assessed weekly for eight weeks via self report.ResultsAll ¡Aptívate! participants used the app at least once, 81.8% of participants used the app ≥8 times, and 36.4% of participants used the app ≥56 times. Weekly retention was strong: 72.7% and 50% of participants continued to use the app at one- and two-months post-enrollment, respectively. Generalized Estimating Equation models indicated a significant interaction between time and treatment, such that ¡Aptívate! participants reported significantly lower depressive symptoms over time than TAU. Depressive symptoms did not differ on average across time between the iCouch and TAU conditions, nor between iCouch and ¡Aptívate!.LimitationsLimitations include small sample size, limited follow-up, and lack of analytics data for the active control condition.ConclusionsWith further research, ¡Aptívate! may offer a feasible, efficacious approach to extend the reach of evidence-based depression treatment for Latinx adults with LEP.
  • Understanding the role of m-health to improve well-being in spouses of
           patients with bipolar disorder
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Rebecca L. Casarez, Emily Barlow, Sriram M. Iyengar, Jair C. Soares, Thomas D. Meyer ObjectivesSpouses and partners of individuals with bipolar disorder (BD) experience significant burden. As there are some limitations to standard psychosocial caregiver interventions, mobile health technology (mHealth) may be a way to reduce burden and improve well-being in these caregivers. The purpose of this study was to explore how the well-being of spouses or partners of patients with BD can be improved through mHealth technology.MethodsUsing a qualitative design, we conducted five focus groups and one in-depth individual interview to collect information from participants about what they would expect from such a device. The sample consists of thirteen participants (eleven spouses and two partners). The age range was 29–65, with eight females and five males. Data were collected using minimally structured interviews and independently analyzed by the authors using content analysis.ResultsResults indicated that the mHealth device many be helpful in at least six areas: reduction of stressors, decreased social isolation, improving communication in the relationship between the spouses, speaking with children about the illness, managing medications, and providing information on resources.ConclusionMobile health technology may be a feasible, available, and cost-effective support tool for spouses and partners of individuals with BD, especially in reducing caregiver stress. Future research is needed to develop the application and test its effectiveness on health outcomes in a larger trial.
  • Heightened sensitivity to panic-related sounds with reduced sensitivity to
           neutral sounds in preattentive processing among panic patients
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Ya Zheng, Ruiying Li, Han Guo, Jingxue Li, Huimin Zhang, Xiaowei Liu, Xiaomei Pang, Bingwei Zhang, Huijuan Shen, Yi Chang BackgroundHypervigilance to panic-related stimuli is believed to play a critical role in the pathogenesis of panic disorder. The current event-related potential study explored whether this hyperresponsivity occurred in the absence of focused attention.MethodsMismatch negativity (MMN) responses to panic-related vs. neutral deviants were assessed in 15 medication-free panic patients without agoraphobia and 16 healthy controls using a reverse-standard-deviant paradigm.ResultsPanic patients relative to healthy controls exhibited an enhanced MMN in response to panic-related sounds but a reduced MMN in response to neutral sounds. Furthermore, MMN responses were delayed in panic patients compared to healthy controls, irrespective of stimulus type.LimitationThe sample size is relatively small.ConclusionsOur data provide evidence that panic disorder was associated with an increased sensitivity to panic-related changes, accompanied by a reduced sensitivity to other acoustic changes as well as a general slow-down of cognitive processing during the preattentive processing stage.
  • Topologically state-independent and dependent functional connectivity
           patterns in current and remitted depression
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Daifeng Dong, Chuting Li, Qingsen Ming, Xue Zhong, Xiaocui Zhang, Xiaoqiang Sun, Yali Jiang, Yidian Gao, Xiang Wang, Shuqiao Yao ObjectiveIdentification of state-independent and -dependent neural biomarkers may provide insight into the pathophysiology and effective treatment of major depressive disorder (MDD), therefore we aimed to investigate the state-independent and -dependent topological alterations of MDD.MethodBrain resting-state functional magnetic resonance imaging (fMRI) data were acquired from 59 patients with unmedicated first episode current MDD (cMDD), 48 patients with remitted MDD (rMDD) and 60 demographically matched healthy controls (HCs). Using graph theory, we systematically studied the topological organization of their whole-brain functional networks at the global and nodal level.ResultsAt a global level, both patient groups showed decreased normalized clustering coefficient in relative to HCs. On a nodal level, both patient groups showed decreased nodal centrality, predominantly in cortex-mood-regulation brain regions including the dorsolateral prefrontal cortex, posterior parietal cortex and posterior cingulate cortex. By comparison to cMDD patients, rMDD group had a higher nodal centrality in right parahippocampal gyrus.LimitationsThe present study, an exploratory analysis, may require further confirmation with task-based and experimental studies.ConclusionsDeficits in the topological organization of the whole brain and cortex-mood-regulation brain regions in both rMDD and cMDD represent state-independent biomarkers.
  • Use of mental health services by community-resident adults with DSM-IV
           anxiety and mood disorders in a violence-prone area: São Paulo, brazil
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Gerda G. Fillenbaum, Sergio L. Blay, Marcelo F. Mello, Maria I. Quintana, Jair J. Mari, Rodrigo A. Bressan, Sergio B. Andreoli BackgroundWhile under-use of mental health services by adults with anxiety and/or depression is well established, use in a violence-prone area, and as a function of diagnosis and personality characteristics such resilience, is little known. We examine the sociodemographic and personality characteristics (specifically resilience), associated with use of mental health services in a violence-prone city by those with anxiety, depression, and their comorbidity.MethodsThe structured Composite International Diagnostic Interview was used to identify 12-month DSM-IV- and ICD-10-defined anxiety and depression in a cross-sectional, representative, community-resident sample age 15–75y (N = 2536) in São Paulo, Brazil, and their use of mental health services. Resilience was determined by the Wagnild and Young scale. Analyses, using weighted, design-corrected statistical tests, included frequency measures and multivariable logistic regression.ResultsMental health services were used by 10% with only anxiety, 22% with only depression, and 34% with comorbidity, with odds of use in controlled analyses doubling from anxiety to depression to comorbidity. Use was significantly higher among those who were white, older (age>30 years, with substantial social support, low resilience, living in low homicide rate areas; use was not affected by experience of traumatic events. Psychiatrists, general practitioners, and psychologists were the primary providers.LimitationsCross-sectional designConclusionsContrary to expectation, use was greater among residents of lower homicide areas, and was not associated with personal traumatic experience. This may reflect increased immunity to violence in higher homicidal rate areas, lower resilience, and poorer access to services. Increased access to mental health services is needed.
  • Leisure-time sedentary behavior and suicide attempt among 126,392
           adolescents in 43 countries
    • Abstract: Publication date: Available online 9 March 2019Source: Journal of Affective DisordersAuthor(s): Davy Vancampfort, Brendon Stubbs, James Mugisha, Joseph Firth, Tine Van Damme, Lee Smith, Ai Koyanagi BackgroundAdolescent suicide is a major global mental health problem. Exploring variables associated with suicide attempts is important for the development of targeted interventions. The aim of the current study was to explore associations between leisure-time sedentary behavior and suicide attempts.MethodsData from the Global School-based Student Health Survey were analyzed. Data on past 12-month suicide attempts and self-reported leisure-time sedentary time were collected. Multivariable logistic regression and meta-analysis were conducted to assess the associations.ResultsAmong 126,392 students from 43 countries (mean age 13.8±0.96 years; 48.9% female), 10.6% had attempted suicide. The prevalence of suicide attempts increased with increasing sedentary leisure-time per day (from 9% at 8 hours/day). Compared to those engaging in 8 hours/day being 1.45 (95% confidence interval=1.19-1.77).LimitationsThe study is cross-sectional, therefore the directionality of the relationships cannot be deduced.ConclusionsOur data suggest that leisure-time sedentary behavior is associated with increased odds for suicide attempt in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public prevention campaigns.
  • Artificial Intelligence Based Discovery of the Association between
           Depression and Chronic Fatigue Syndrome
    • Abstract: Publication date: Available online 8 March 2019Source: Journal of Affective DisordersAuthor(s): Feilong Zhang, Chuanhong Wu, Caixia Jia, Kuo Gao, Jinping Wang, Huihui Zhao, Wei Wang, Jianxin Chen BackgroundBoth of the modern medicine and the traditional Chinese medicine classify depressive disorder (DD) and chronic fatigue syndrome (CFS) to one type of disease. Unveiling the association between depressive and the fatigue diseases provides a great opportunity to bridge the modern medicine with the traditional Chinese medicine.MethodsIn this work, 295 general participants were recruited to complete Zung Self-Rating Depression Scales and Chalder Fatigue Scales, and meanwhile, to donate plasma and urine samples for 1H NMR-metabolic profiling. Artificial intelligence methods was used to analysis the underlying association between DD and CFS. Principal components analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were used to analyze the metabolic profiles with respect to gender and age. Variable importance in projection and t-test were employed in conjunction with the PLS-DA models to identify the metabolite biomarkers. At last, PCA was used to analyze the data characteristics between DD and CFS.ResultsThe results showed the gender- and age-related differences for the candidate biomarkers of the DD and the CFS diseases, and indicated the same and different biomarkers of the two diseases. PCA analysis for the data characteristics reflected that DD and CFS was separated completely in plasma metabolite. However, DD and CFS was merged into one group.LimitationLack of transcriptomic analysis limits the understanding of the association of the DD and the CFS diseases on gene level.ConclusionThe unmasked candidate biomarkers provide reliable evidence to explore the commonality and differences of the depressive and the fatigue diseases, and thereby, bridge over the traditional Chinese medicine with the modern medicine.
  • Screening for perinatal anxiety disorders: Room to grow
    • Abstract: Publication date: Available online 8 March 2019Source: Journal of Affective DisordersAuthor(s): Nichole Fairbrother, Bryony Corbyn, Dana S. Thordarson, Annie Ma, Danika Surm BackgroundThe anxiety and their related disorders (AD) are the most prevalent of all mental health conditions, disproportionately affecting women. The value of perinatal AD screening is well established but there is very limited evidence to support the applicability of existing anxiety screening instruments. To our knowledge, no previous studies have evaluated an AD screening instrument in a perinatal population using full gold standard methodology.ObjectiveTo assess the accuracy of the most commonly used and/or recommended screening tools for perinatal AD (i.e., the Edinburgh Postnatal Depression Scale (EPDS) and its anxiety subscale (EPDS-3A), and the Generalized Anxiety Disorder 7 and 2-item Scales (GAD-7 and GAD-2) alongside a clinically derived alternative; the Anxiety Disorder – 13 (AD-13).Methods310 Canadian women completed mood and anxiety questionnaires at approximately 3-months postpartum. Those scoring at/above cut-off on one or more questionnaire completed a diagnostic interview for depression and all AD (n = 115). The accuracy of each scale was assessed via ROC analyses.ResultsOnly the AD-13 met the standard of a clinically useful screening measure, with an area under the curve (AUC) above .8. This was achieved with and without the inclusion of the related disorders. No other measure demonstrated an AUC above .8, either including or excluding the related disorders.ConclusionsNeither the EPDS/EPDS 3-A, nor the GAD-7/GAD-2 can be recommended for widespread use as a perinatal AD screening tool. The high performance of the AD-13 is a good indication that an effective alternative is well within reach.
  • Brain IGFBP-5 Modifies the Relation of Depressive Symptoms to Decline in
           Cognition in Older Persons
    • Abstract: Publication date: Available online 8 March 2019Source: Journal of Affective DisordersAuthor(s): Ana W. Capuano, Robert S. Wilson, William G. Honer, Vladislav A. Petyuk, Sue E. Leurgans, Lei Yu, Jennifer R. Gatchel, Steven Arnold, David A. Bennett, Zoe Arvanitakis Background: Brain proteins, including Insulin-like Growth Factor Binding Protein 5 (IGFBP-5), have been associated with cognitive dysfunction in aging. Mechanisms linking depression with cognition are poorly understood. We hypothesize that the association of depressive symptoms with cognition is mediated or modified by brain proteins.Methods: IGFBP-5, HSPB2, AK4, ITPK1 and PLXNB1 were measured in dorsolateral prefrontal cortex in 1057 deceased participants, who underwent annual assessments of depressive symptoms and cognition for a mean of 8.9 years. The average number of depressive symptoms per year before a dementia diagnosis was calculated for each person.Results: A one standard deviation above the mean IGFBP-5 was associated with a 14% higher odds of having more depressive symptoms (p
  • Cognitive-functional relationships in major depressive disorder: Crucial
           data from a Ukrainian open-label study of vortioxetine versus escitalopram
    • Abstract: Publication date: 1 May 2019Source: Journal of Affective Disorders, Volume 250Author(s): Oleg A. Levada, Alexandra S. Troyan BackgroundMajor depressive disorder (MDD) is one of the most prevalent mental illnesses associated with impairments in different spheres of functioning. Cognitive deficits are currently investigated as a possible factor of functional decline. We aimed: 1) to assess the influence of cognitive domains among other MDD symptoms on functional impairment; 2) to compare effects of eight weeks` vortioxetine versus escitalopram treatments on cognitions and consequent influence on various domains of functioning.MethodsAt baseline, 119 MDD (according to DSM-5, MADRS ≥ 7) patients and 71 healthy controls completed neurocognitive tests (RAVLT, TMT-B, DSST) and Sheehan Disability Scale. After 8 weeks of vortioxetine/escitalopram treatment, 56 patients had repeated clinical and neuropsychological evaluations. Linear regression analyses were performed to find significant predictors of impairment (at baseline) and improvement (after treatment) of functioning. Differences between groups after treatment were analyzed using mixed models for repeated measurements.ResultsCognitive impairments predominantly affected social functioning and were crucial for working productivity and total functioning along with anhedonia, hypothymia. Working memory disturbances impaired all aspects of functioning. Executive dysfunction made an additional contribution to workplace performance disturbances. At week 8, vortioxetine compared with escitalopram greater improved all impaired cognitive parameters and aspects of functioning and had higher remission rates. Cognitive improvement was the most significant factor for total functioning recovery and among crucial contributors to workplace performance recovery.LimitationsNo placebo group.ConclusionCognitions play a key role in social, working, overall functioning in Ukrainian MDD patients. Compared to escitalopram, vortioxetine treatment greater improves all cognitive and functioning domains, which leads to higher remission rates.
  • Characterization of Cortical and Subcortical Abnormalities in Drug-Naive
           Boys with Attention-Deficit/Hyperactivity Disorder
    • Abstract: Publication date: Available online 8 March 2019Source: Journal of Affective DisordersAuthor(s): Lu Lu, Lianqing Zhang, Shi Tang, Xuan Bu, Ying Chen, Xinyu Hu, Xiaoxiao Hu, Hailong Li, Lanting Guo, John A. Sweeney, Qiyong Gong, Xiaoqi Huang Background: The current study was designed to investigate the anatomical differences in cortical and subcortical morphometry between drug-naive boys with attention-deficit/hyperactivity disorder (ADHD) and healthy controls (HCs) using three-dimensional T1-weighted imaging and to explore the effects of age on morphometric abnormalities.Methods: Fifty-three drug-naive boys with ADHD and 53 HCs underwent high-resolution anatomical magnetic resonance (MR) imaging using a 3-T MR scanner. The FreeSurfer image analysis suite was used to obtain measures of cortical volume, thickness, and surface area, as well as the volumes of 14 subcortical structures. Statistically significant differences in measures between children with ADHD and HCs were evaluated using a least general linear model, with the intracranial volume and age as covariates.Results: Compared to HCs, boys with ADHD exhibited an increased cortical volume in the left frontal eye field (FEF), a decreased surface area in the left ventral frontal cortex (VFC), and a decreased volume in the right putamen (cluster-wise p
  • Affective symptoms and apathy in myotonic dystrophy type 1 A systematic
           review and meta-analysis
    • Abstract: Publication date: Available online 7 March 2019Source: Journal of Affective DisordersAuthor(s): Bianca GJ van der Velden, Kees Okkersen, Roy PC Kessels, Johannes Groenewoud, Baziel van Engelen, Hans Knoop, Joost Raaphorst BackgroundTo gain insight into the prevalence of apathy, depression and anxiety symptoms in myotonic dystrophy type 1 (DM1) patients on the basis of a systematic review with a meta-analysis.MethodsOne author systematically searched and selected studies from Embase, Medline, PsychInfo and Web of Science (index periods up to August 2018). Data extraction and bias assessment were performed independently by two authors. We calculated (1) a weighted pooled prevalence and (2) weighted pooled standardized mean difference (Hedges’ g) from studies comparing DM1 patients to healthy and/or neuromuscular disease controls separately for symptoms of depression, anxiety and apathy.ResultsThe pooled prevalences of depression (26 studies, n = 1267 DM1 patients), anxiety (19 studies, n = 896) and apathy (5 studies, n = 428), were 18% (95%CI: 12-25), 16 (95%CI: 13-18) and 55% (95%CI: 55-60), respectively. Effect sizes (Hedges’ g) for depression, anxiety and apathy in DM1 patients compared to healthy controls were 1.04 (95%-CI: 0.71 to 1.37), 0.87 (95%-CI: 0.51 to 1.24) and 1.13 (95%-CI:0.54-1.71). Effect sizes for symptoms of depression, anxiety and apathy were 0.29 (95% CI: -0.12 to 0.70), 0.45 (95%-CI: -0.31 to 1.22) and 1.12 (95%-CI: 0.32-1.93) for DM1 patients versus neuromuscular disease controls. In most analyses, statistical heterogeneity was high.ConclusionsEstimated pooled prevalences of clinically significant levels of symptoms of depression, anxiety and apathy in DM1 are 19, 17 and 55% respectively. Symptoms of depression and anxiety in DM1 may reflect reactive adjustment to progressive impairment and restricted participation similar to other chronic neuromuscular disease. The literature on the prevalence and severity of apathy, although a clinically relevant and characteristic symptom of DM1, is relatively scarce.
  • Potential serum biomarkers for the prediction of the efficacy of
           escitalopram for treating depression
    • Abstract: Publication date: Available online 7 March 2019Source: Journal of Affective DisordersAuthor(s): Yuhao Xu, Hong Wei, Yuanyuan Zhu, Yan Zhu, Ningning Zhang, Jiasheng Qin, Xiaolan Zhu, Ming Yu, Yuefeng Li BackgroundAlthough several pharmacological treatment options for depression are currently available, a large proportion of patients still do not achieve a complete remission or respond adequately to the initial antidepressant prescribed for reasons that remain relatively unknown. This study explored the application of serum biomarkers to the predict the efficacy of escitalopram for treating depression, to guide clinical drug selection.MethodIn this study, 306 patients suffering from depression were treated with escitalopram (10 mg) for 6 weeks. After 6 weeks of treatment, the patients were divided into an escitalopram-sensitive group (ES, n=172) and an escitalopram-insensitive group (EIS, n=134) according their HAMD-24 scores after 6 weeks of treatment. Serum samples from all participants were collected on the first day, and 10 different serum biomarkers were analysed. Data from 100 patients in the ES group and 100 patients in the EIS group were then used to build a logistic regression model, and a receiver operating characteristic (ROC) curve was drawn. To validate the accuracy of our model, another 72 patients in the ES group and 34 patients in the EIS group were studied.ResultsOf the 10 selected serum biomarkers, 4 were screened to build the regression model. BDNF, FGF-2, TNF-α and 5-HT. The regression equation was Z= 1/[1+e − (-5.065 +0.145 (BDNF)+0.029 (FGF-2) - 0.368 (TNF-α) + 0.813 (5-HT))], and the 4 biomarkers-combined detection achieved an AUC (area under the ROC curve) of 0.929 and a predictive accuracy of 88.70%.LimitationDecision support tools based on our combined biomarker prediction models hold comparatively great promises; however, they need to be validated on a much larger scales than current studies provide.ConclusionThe logistic regression model and ROC curves based of the serum biomarkers used in this study provide a more reliable means to predict the efficacy of escitalopram in patients with depression, and provide clinical evidence for drug selection.
  • PTSD Symptom Profiles Among Louisiana Women Affected by the 2010 Deepwater
           Horizon Oil Spill: A Latent Profile Analysis
    • Abstract: Publication date: Available online 6 March 2019Source: Journal of Affective DisordersAuthor(s): Nicole Nugent, Symielle A. Gaston, Jacqueline Perry, Ariane L. Rung, Edward J. Trapido, Edward S. Peters BackgroundFew prior studies have investigated the latent class structure of PTSD using DSM-5 symptoms.MethodsTo describe latent PTSD profiles among women who resided in Deepwater Horizon Oil Spill (DHOS)-affected coastal Louisiana communities, we used data from women enrolled in The Women and Their Children's Health (WaTCH) Study. Latent profile analysis was performed on the 20-item PTSD Checklist for DSM-5 (PCL-5) and model fit statistics for 2-class through 6-class solutions were compared. The pseudo-class draws method was employed on the best class solution to compare key covariates (including demographics, mental health indicators, DHOS exposure indicators, and trauma exposures) across classes.ResultsAmong 1997 women (mean age 46.63±12.14 years, 56.8% white, mean trauma categories 6.09±2.98, 9.55% previously diagnosed with PTSD), model fit statistics supported a five-class solution: low symptoms (mean PCL-5=4.10), moderate without mood alterations (mean=19.73), moderate with mood alterations (mean=34.24), severe without risk-taking (mean=55.75), and severe with risk-taking (mean=53.80). Women in the low-symptom class were significantly more likely to be white, have finished high school, have an income of at least $40,001 per year, be married or living with a partner, and endorse fewer trauma categories than women in the four symptomatic classes. Women with moderate to severe symptoms often had co-morbid depressive symptoms and no prior PTSD diagnosis.LimitationsThis study was limited by use of self-reported data and one-time assessment of PTSD symptoms.DiscussionFive distinct latent profiles of DSM-5 PTSD symptoms consisted of notably different individuals. Most affected women did not report prior PTSD diagnosis. Future research and practice identifying and addressing barriers to care for trauma-affected women in these communities is warranted.
  • Social capital and perceived stress: The role of social context
    • Abstract: Publication date: Available online 6 March 2019Source: Journal of Affective DisordersAuthor(s): Sehee Han BackgroundThe aim of this study is twofold: to investigate how much variance in individual perceived stress is attributed to household and area levels, respectively, and to examine the association between social capital at the individual, household, and area levels and perceived stress, while adjusting for various cofounders at the individual, household, and area levels. Methods: This study used data from the 2010 Seoul Welfare Panel Study conducted by the Seoul Welfare Foundation. A total sample of 5,881 individuals in 2,820 households within 25 areas was used for multilevel analysis.ResultsThe results showed that a relatively large proportion of variance in perceived stress was attributed to the household level (45.86%) in comparison with the area level (6.96%), which indicates that household or family context is more important in explaining variance in perceived stress than area. This study also found that some components of social capital were negatively associated with perceived stress, and the association between social capital and perceived stress varied depending on levels and types of social capital measures.LimitationsThis study is based on a cross-sectional design, and thus it is not clear about the temporal order between the relationship between social capital and perceived stress.ConclusionsOverall, this study showed that research on social capital and mental health can be advanced by systematically investigating the role of household social capital, not just geographical social capital.
  • Short-term prediction of suicidal thoughts and behaviors in adolescents:
           Can recent developments in technology and computational science provide a
    • Abstract: Publication date: Available online 6 March 2019Source: Journal of Affective DisordersAuthor(s): Nicholas B. Allen, Benjamin W. Nelson, David Brent, Randy P. Auerbach BackgroundSuicide is one of the leading causes of death among adolescents, and developing effective methods to improve short-term prediction of suicidal thoughts and behaviors (STBs) is critical. Currently, the most robust predictors of STBs are demographic or clinical indicators that have relatively weak predictive value. However, there is an emerging literature on short-term prediction of suicide risk that has identified a number of promising candidates, including (but not limited to) rapid escalation of: (a) emotional distress, (b) social dysfunction (e.g., bullying, rejection), and (c) sleep disturbance. However, these prior studies are limited in two critical ways. First, they rely almost entirely on self-report. Second, most studies have not focused on assessment of these risk factors using intensive longitudinal assessment techniques that are able to capture the dynamics of changes in risk states at the individual level.MethodIn this paper we explore how to capitalize on recent developments in real-time monitoring methods and computational analysis in order to address these fundamental problems.ResultsWe now have the capacity to use: (a) smartphone, wearable computing, and smart home technology to conduct intensive longitudinal assessments monitoring of putative risk factors with minimal participant burden and (b) modern computational techniques to develop predictive algorithms for STBs. Current research and theory on short-term risk processes for STBs, combined with the emergent capabilities of new technologies, suggest that this is an important research agenda for the future.LimitationsAlthough these approaches have enormous potential to create new knowledge, the current empirical literature is limited. Moreover, passive monitoring of risk for STBs raises complex ethical issues that will need to be resolved before large scale clinical applications are feasible.ConclusionsSmartphone, wearable, and smart home technology may provide one point of access that might facilitate both early identification and intervention implementation, and thus, represents a key area for future STB research.
  • Predicting relapse in major depression after successful initial
           pharmacological treatment
    • Abstract: Publication date: Available online 5 March 2019Source: Journal of Affective DisordersAuthor(s): Tatsuo Akechi, Akio Mantani, Ken'ichi Kurata, Susumu Hirota, Shinji Shimodera, Mitsuhiko Yamada, Masatoshi Inagaki, Norio Watanabe, Tadashi Kato, Toshi A. Furukawa, for the SUND InvestigatorsABSTRACTBackgroundIdentifying the predictors of relapse could help to develop more individualized treatment strategies for major depression. The study aim was to explore predictors of depression relapse after remission using data from our previous multicenter randomized practical trial of patients with major depression.MethodsOur cohort comprised subjects with Patient Health Questionnaire (PHQ-9) scores less than 5 after antidepressant treatment for 9 weeks. Relapse was defined as a PHQ-9 score of 5 or more at week 25. We examined patient demographic and clinical characteristics at baseline (age, sex education, job status, marital status, onset age at first depressive episode, number of previous episodes, length of current episode, scores on the nine PHQ-9 criteria at week 0) and Frequency, Intensity, and Burden of Side Effects Rating Scale and PHQ-9 total scores at week 9 (residual symptoms) as potential predictors of depression relapse at week 25.ResultsOf 494 patients remitted at week 9, 71 (14.4%) experienced relapse at week 25. Logistic regression analysis showed that lower PHQ-9 depressive mood score at week 0, higher suicidal ideation score at week 0, and total PHQ-9 score at week 9, and greater severity of side effects at week 9 were significant predictors. On the other hand, when relapse was defined as a PHQ-9 score of 10 or more at week 25, there were no significant predictors.LimitationsThere may be other important predictors that this study failed to identify and the findings obtained may be sensitive to the specific definition of relapse.ConclusionsApproximately one-seventh of subjects who remitted after 2 months of acute-phase treatment experienced depression relapse within 4 months of remission. Lower depressive mood and higher suicidal ideation upon development of the current depression episode, the presence of residual symptoms, and greater severity of side effects at remission may predict subsequent depression relapse.
  • Buffering against maladaptive perfectionism in bipolar disorder: the role
           of self-compassion
    • Abstract: Publication date: Available online 4 March 2019Source: Journal of Affective DisordersAuthor(s): Kathryn Fletcher, Yan Yang, Sheri L. Johnson, Michael Berk, Tania Perich, Sue Cotton, Steven Jones, Sara Lapsley, Erin Michalak, Greg Murray Background: Maladaptive perfectionism is a transdiagnostic risk and maintaining factor for a range of mental health conditions, including bipolar disorder (BD). Self-compassion represents a potential protective factor against maladaptive perfectionism, however no studies to date have examined the relationship of these constructs in BD. The aim of the present study was to examine associations between maladaptive perfectionism, self-compassion and symptoms among individuals with BD.Methods: Baseline data were collected from 301 participants with a DSM-IV diagnosis of BD participating in an international randomised controlled trial. Participants completed measures of maladaptive perfectionism, self-compassion, symptom severity and emotion regulation difficulties. Clinician-administered measures of depression and mania severity were additionally collected. Correlation and mediation analyses were conducted.Results: Maladaptive perfectionism was positively associated with depression, anxiety and emotion regulation difficulties. Lower levels of self-compassion correlated with greater self-reported depression, anxiety and emotion regulation difficulties. Self-compassion partially mediated relationships between maladaptive perfectionism, depression, anxietyand emotion regulation difficulties.Limitations: The cross-sectional design limits conclusions about causal relationships between study variables. Results may not be generalizable to other BD populations. The role of maladaptive perfectionism and self-compassion in elevated mood states of BD remains unclear.Conclusion: Self-compassion represents one mechanism through which maladaptive perfectionism influences symptoms of depression, anxiety and emotion regulation difficulties in BD. Self-compassion represents a modifiable treatment target; individuals with BD exhibiting maladaptive perfectionistic tendencies may benefit from interventions fostering self-compassion.
  • Plasma Serotonin Levels are Associated with Antidepressant Response to
    • Abstract: Publication date: Available online 26 February 2019Source: Journal of Affective DisordersAuthor(s): Amanda Holck, Owen M Wolkowitz, Sindy H Mellon, Victor I Reus, J Craig Nelson, Åsa Westrin, Daniel Lindqvist Background: Less than half of patients with major depressive disorder (MDD) respond to their first antidepressant trial. Our understanding of the underlying mechanisms of selective serotonin reuptake inhibitors (SSRIs) remains poor, and there is no reliable method of predicting treatment response.Methods: Thirty-seven MDD subjects and 41 healthy controls, somatically healthy and medication-free for at least six weeks, were recruited, and plasma serotonin (5-HT) levels were assessed at baseline. Twenty-six of the MDD subjects were then treated in an open-label manner with clinically appropriate doses of sertraline for 8 weeks, after which plasma 5-HT levels were again assessed. Response to treatment was defined as an improvement of 50 % or more on the Hamilton Depression Rating Scale.Results: Non-responders to sertraline treatment had significantly lower pre-treatment 5-HT levels compared to both healthy controls and responders (F=4.4, p=0.004 and p=0.036 respectively). There was a significant decrease in 5-HT levels over treatment in all MDD subjects (t=6.2, p=0.000003). The decrease was significantly more prominent in responders compared to non-responders (t=2.1, p=0.047). There was no significant difference in post-treatment 5-HT levels between responders and non-responders.Limitations: The study had a modest sample size. 5-HT levels in plasma may not reflect 5-HT levels in the brain.Conclusions: The results indicate that SSRI response may be facilitated by adequate baseline plasma 5-HT content and that successful SSRI treatment is associated with greater decreases in circulating 5-HT. Plasma 5-HT content may be a predictor of SSRI treatment outcome. Potential underlying mechanisms are discussed.
  • The impact of resilience on prenatal anxiety and depression among pregnant
           women in Shanghai
    • Abstract: Publication date: Available online 26 February 2019Source: Journal of Affective DisordersAuthor(s): Xuemei Ma, Ying Wang, Hua Hu, Xuguang Grant Tao, Yunhui Zhang, Huijing Shi Background: Prenatal anxiety/depression has been a major public health problem globally with higher prevalence in developing countries, which leads to negative health outcomes for both mothers and children. Maternal stress varies over the course of pregnancy and the stress occurring in early pregnancy is the most critical. However, few studies have focused on the impact of resilience to stress on mental health of pregnant women.Aims: To explore the effect of resilience to stress on prenatal anxiety/depression in pregnant women.Methods: 2813 participants were recruited from Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC) in this study. The Life Event Scale for Pregnancy Women (LESPW) was used to assess stress at 12-16 weeks of pregnancy and at 32-36 weeks of pregnancy, respectively. Resilience was assessed by the revised Resilience Scale for Adults (RSA) at 12-16 weeks of pregnancy. The prenatal anxiety and depression were assessed at 32-26 weeks of pregnancy by Self-Rating Anxiety Scale (SAS) and the Center for Epidemiological Survey, Depression Scale (CES-D), respectively. Hierarchical linear regression analyses were conducted to explore the direct effect of stress and resilience on prenatal anxiety and depression. The indirect effects of mediation were analyzed by structural equation models, and the indirect effect of modification was examined by stratification analysis.Results: There were 11.1% and 10.3% of pregnant women in Shanghai MCPC indicating anxiety and depressive mood, respectively. The stress caused by both subjective and objective events at 32-36 weeks of pregnancy is less than that at 12-16weeks of pregnancy. We found that resilience was a protective factor for maternal mental health and meanwhile it was both an effect modifier and a mediator to the association between stress and prenatal anxiety/depression, with the mediating effect ratio of 15.1% and 23.8%, respectively.Limitations: The existence of recall bias, missing data, and restricted residential areas of the participants may limit the generalizability of the study. The measurements of resilience, prenatal anxiety, and depression were not designed specifically for pregnant women, so that they might have missed some important indications of mental issues related to pregnant women only.Conclusions: Resilience could be a direct and indirect protective factor for prenatal anxiety and depression caused by pregnancy stress.
  • Effects of melatonin administration on mental health parameters, metabolic
           and genetic profiles in women with polycystic ovary syndrome: a
           randomized, double-blind, placebo-controlled trial
    • Abstract: Publication date: Available online 26 February 2019Source: Journal of Affective DisordersAuthor(s): Azade Shabani, Fatemeh Foroozanfard, Elham Kavossian, Esmat Aghadavod, Vahidreza Ostadmohammadi, Russel J. Reiter, Tahereh Eftekhar, Zatollah Asemi ObjectiveThe aim of this study was to evaluate the effect of melatonin supplementation on mental health parameters, metabolic and genetic parameters in women suffering from polycystic ovary syndrome (PCOS).MethodsThis randomized, double-blinded, placebo-controlled clinical trial was performed on 58 subjects, aged 18-40 years old. Subjects were randomly allocated to take either 10 mg melatonin (2 melatonin capsules, 5 mg each) (n=29) or placebo (n=29) once a day 1 h before bedtime for 12 weeks. Glycemic control and lipid profiles were measured at baseline and after the 12-week intervention. Using RT-PCR method, gene expression related to insulin and lipid metabolism was conducted on peripheral blood mononuclear cells (PBMCs) of PCOS women.ResultsMelatonin supplementation significantly decreased Pittsburgh Sleep Quality Index (β -2.15; 95% CI, -3.62, -0.68; P=0.005), Beck Depression Inventory index (β -3.62; 95% CI, -5.53, -1.78; P
  • Risk of Attempted Suicide among Adolescents and Young Adults with
           Traumatic Brain Injury: A Nationwide Longitudinal Study
    • Abstract: Publication date: Available online 26 February 2019Source: Journal of Affective DisordersAuthor(s): Hsuan-Kan Chang, Ju-Wei Hsu, Jau-Ching Wu, Kai-Lin Huang, Huang-Chou Chang, Ya-Mei Bai, Tzeng-Ji Chen, Mu-Hong Chen BackgroundTraumatic brain injury (TBI) and suicidal behavior lead to serious morbidity and premature mortality. TBI in adulthood is associated with a higher incidence of suicide, but the risk in adolescents and young adults is not clear.MethodsLongitudinal follow-up data were extracted from a National Health Insurance Research Database. Adolescents and young adults (12–29 years old) with and without TBI (1:4) were included, and the incidences of following attempted suicide were analyzed. The association of TBI severity, repeated TBI, and comorbid psychiatric disorders with attempted suicide were also investigated.ResultsOverall, 31,599 and 126,396 subjects were enrolled in the TBI and control cohorts, respectively. The overall incidence of attempted suicide was significantly higher in the TBI cohort than in the control cohort (4.6% versus 1.0%, P < 0.001). The age at first suicide attempt was also lower in the TBI cohort (25.71 ± 5.25 versus 28.99 ± 5.26 years, P < 0.001). After adjusting for confounding factors, severe TBI, repeated TBI, female, younger age at TBI, and comorbid psychiatric conditions (unipolar depression, bipolar disorder, alcohol and substance use disorders) were associated with higher risks of attempted suicide. Long-term cumulative risks of attempted suicide were significantly elevated in the TBI cohort (P < 0.001).LimitationAccess to individual's detailed medical record was not available.ConclusionTBI is associated with an elevated risk of attempted suicide in adolescents and young adults. TBI severity, repetitive injury, female, younger age at injury, and certain psychiatric comorbidities are independent risk factors.
  • Exploring comorbidity between anxiety and depression among migrant
           Filipino domestic workers: A network approach
    • Abstract: Publication date: Available online 26 February 2019Source: Journal of Affective DisordersAuthor(s): Melissa R. Garabiles, Chao Kei Lao, Yingxin Xiong, Brian J. Hall Background: Depression and anxiety are comorbid. From the network model perspective, comorbidity is due to direct interactions between depression and anxiety symptoms. These interacting symptoms are called bridge symptoms, suppression of which is expected to halt other symptoms. This study investigates the network structure of depression, anxiety, and bridge symptoms in a sample of migrant domestic workers, who are among the most vulnerable and marginalized groups of workers.Method: Data were collected from 1375 Filipino domestic workers in Macao Special Administrative Region, China. Data from a subsample of 355 consisting of participants who met criteria for depression and anxiety were used in analysis. R software was used to estimate the network.Results: The eight strongest edges were between items from the same disorder. Six were between depression symptoms, like “concentration difficulties” and “psychomotor agitation/retardation,” and “psychomotor agitation/retardation” and “thoughts of death.” Two were between anxiety symptoms, including “worry too much” and “trouble relaxing.” For centrality indices, “fatigue” had highest strength and closeness, and “restlessness” had highest betweenness. Results revealed three bridge symptoms: “fatigue,” “depressed mood,” and “anhedonia.”Limitations: The results may not generalize to the entire Filipino population. Further, while the centrality index of strength had adequate stability, it was not highly stable.Conclusions: The current study highlighted critical transdiagnostic bridge symptoms as specific candidates for intervention. “Psychomotor agitation/retardation” was identified as key priority due to its association with suicidal ideation. Systemic multilevel interventions at the person-level (e.g., cognitive therapy and behavioral activation), and at the structural and policy-level to alleviate psychosocial stressors, could be applied to address disorder comorbidity in this population.
  • Online social work engagement and empowerment for young Internet users: A
    • Abstract: Publication date: Available online 26 February 2019Source: Journal of Affective DisordersAuthor(s): Yik Wa Law, Chi Leung Kwok, Pik Ying Chan, Melissa Chan, Paul Yip BackgroundThe increasing penetration of Internet use among young people poses challenges for youth service engagement through bricks-and-mortar youth centers owing to the decline in the number of walk-ins. This study was to identify the psychosocial and behavioral outcome changes effected through online engagement and empowerment interventions offered to at-risk youths by three local social work youth service providers.MethodsA quasi-experimental design was adopted to compare the effects of online engagement and empowerment on 182 young service users with 191 age- and gender-matched controlled participants over nine months.ResultsSignificant improvement in emotional distress and social withdrawal behaviors were found in the intervention group.LimitationsNon-randomized study, nonequivalent comparison groupDiscussionWhether online social work services can substitute offline services should be further examined in randomized controlled trials. Online social work intervention identifies its acceptability among young people and professional feedback holds promise for providing a complimentary route of alleviating emotional distress and social withdrawal in at-risk youths.
  • Non-Suicidal Self-Injury and Electroconvulsive Therapy: Outcomes in
           Adolescent and Young Adult Populations
    • Abstract: Publication date: Available online 25 February 2019Source: Journal of Affective DisordersAuthor(s): Kelly Rootes-Murdy, Marianna Carlucci, Michael Tibbs, Lee E. Wachtel, Martin F. Sherman, Peter Zandi, Irving M. RetiABSTRACTBackground: Electroconvulsive (ECT) therapy is a highly effective treatment for severe depression. Although the clear majority of patients respond to ECT, not all do, and we still lack good predictors for ECT outcome, especially in adolescents and young adults. One clinical variable that has been associated with reduced likelihood of ECT antidepressant response in adults is comorbid borderline personality disorder. As self-injurious behavior is often a feature of borderline personality disorder, we hypothesized that adolescent and young adult patients with a history of non-suicidal self-injury (NSSI), who were being treated for major depression with ECT, would have a poorer response than patients without such a history.Methods: We conducted a retrospective chart review of 48 patients treated with ECT for depression at The Johns Hopkins Hospital between the ages of 14 and 25.Results: Initial analyses showed that the presence of NSSI was not associated with ECT outcomes. However, sub-group analyses suggested that it was associated with response to ECT and overall remission among female patients. Specifically, the results suggested that in adolescent and young adult female ECT patients, the presence of NSSI was associated with lower odds of response (OR: 0.04; 95% CI: 0.0004, 0.81, p = 0.03) and remission (OR: 0.09; 95% CI: 0.0000, 0.81, p = 0.03), and a greater mean number of treatments (5.83; 95% CI: 0.27, 11.39, p = 0.04) compared with patients without NSSI.Conclusions: Clearly, the finding that NSSI may be associated with poorer ECT outcomes among female patients needs to be replicated. Nonetheless, our data suggest caution when considering an adolescent or young adult woman for a course of ECT.
  • Prevalence of depressive symptoms in overweight and obese children and
           adolescents in mainland China: a meta-analysis of comparative studies and
           epidemiological surveys
    • Abstract: Publication date: Available online 20 February 2019Source: Journal of Affective DisordersAuthor(s): Wen-Wang Rao, Ji-Wen Zhang, Qian-Qian Zong, Feng-Rong An, Gabor S. Ungvari, Lloyd Balbuena, Fang-Yu Yang, Yu-Tao Xiang BackgroundObesity is associated with a higher risk of depression in children and adolescents. This is a meta-analysis of studies examining depressive symptoms in overweight and obese children and adolescents in China.MethodsA systematic literature search was performed independently in both English (PubMed, EMBASE, Web of Science and Medline Complete) and Chinese (China National Knowledge Internet, WANFANG Data and WeiPu VIP) databases from their commencement date to December 31, 2018. The pooled prevalence of depressive symptoms was calculated using a random-effects model. Data analyses were performed with STATA Version 12.0, R Version 3.3.0 and R Studio Version 0.99.903.ResultsNineteen epidemiological and 16 comparative studies were included in the meta-analysis. The overall prevalence of depressive symptoms was 24.02% (95%CI: 15.92%-33.16%) in obese children and adolescents and 22.61% (95%CI: 14.87%-31.34%) in overweigh children and adolescents. Obese children and adolescents were more likely to suffer from depressive symptoms (OR = 1.877, 95%CI: 1.459-2.415, P
  • Predominant polarity in bipolar disorder patients: the COPE bipolar sample
    • Abstract: Publication date: Available online 20 February 2019Source: Journal of Affective DisordersAuthor(s): Othman Sentissi, Dina Popovic, Clotilde Moeglin, Yelena B. Stukalin, Mariella Mosheva, Alessandro Serretti, Daniel SoueryABSTRACTBackgroundThe concept of predominant polarity (PP) is defined as presenting more symptoms of one polarity. Previous studies have defined PP as one polarity (either a depression or mania episode) occurring during at least two-thirds of the lifetime.MethodsWe conducted an observational study with the COPE-BD (Clinical Outcome and Psycho-Education for Bipolar Disorder, Clinical Outcome Measures Section) dataset to identify the diagnostic and treatment differences between bipolar disorder (BD) patients with and without PP.ResultsThe final sample included 210 BD-I (59.0%) and 146 BD-II (41.0%) patients. Of these, 28.9% patients presented predominant polarity (PP): 62 (17.4%) of those patients were depressed polarity predominant (DPP), 41 (11.5%) were manic polarity predominant (MPP), and 253 (71.1%) met criteria for bipolar disorders but did not present with PP. In comparison to this group of BD patients with undetermined polarity, the group of BD patients with PP presented more rapid cycling.Furthermore, in the undetermined polarity group, the onset of illness occurred earlier, and the duration of the illness was longer, with more hypomanic/manic and depressive episodes than patients who met the PP criteria.LimitationsThis study has a naturalistic and retrospective design and does not allow a specific follow-up of polarity over time.ConclusionsThese different clinical characteristics underline the importance of considering PP in patients with BD, and justify the need for differential treatment approach which could have an impact on patients' prognosis. Yet, more independent and prospective research is needed to confirm these findings, especially with the new classification of DSM-5 concerning mixed states.
  • A prediction model for duration of sickness absence due to stress-related
    • Abstract: Publication date: Available online 20 February 2019Source: Journal of Affective DisordersAuthor(s): Katalin Gémes, Paolo Frumento, Gino Almondo, Matteo Bottai, Johanna Holm, Kristina Alexanderson, Emilie Friberg BackgroundStress-related disorders are leading causes of long-term sickness absence (SA) and there is a great need for decision support tools to identify patients with a high risk for long-term SA due to them.AimsTo develop a clinically implementable prediction model for the duration of SA due to stress-related disorders.MethodsAll new SA spells with F43 diagnosis code lasting>14 days and initiated during 2010-01-01 and 2012-06-30 were identified through data from the Social Insurance Agency. Information on baseline predictors were linked on individual level from other nationwide registers. Piecewise-constant hazard regression was used to predict the duration of the SA. Split-sample validation was used to develop and validate the model, and c-statistics and calibration plots to evaluate it.ResultsOverall 83,443 SA spells, belonging to 77,173 individuals were identified. The median SA duration was 55 days (10% were>365 days). Age, sex, geographical region, employment status, educational level, extent of SA at start and SA days, outpatient healthcare visits, and multi-morbidity in the preceding 365 days were selected to the final model. The model was well calibrated. The overall c-statistics was 0.54 (95% confidence intervals: 0.53-0.54) and 0.70 (95% confidence intervals: 0.69-0.71) for predicting SA spells>365 days.LimitationsThe heterogeneity of the F43-diagnosis and the exclusive use of register-based predictors limited our possibility to increase the discriminatory accuracy of the prediction.Conclusion: The final model could be implementable in clinical settings to predict duration of SA due to stress-related disorders and could satisfyingly discriminate long-term SA.
  • Comparison of DSM-5 Criteria for Persistent Complex Bereavement Disorder
           and ICD-11 Criteria for Prolonged Grief Disorder in Help-Seeking Bereaved
    • Abstract: Publication date: Available online 19 February 2019Source: Journal of Affective DisordersAuthor(s): Paul A. Boelen, Mariken Spuij, Lonneke I.M. Lenferink Background: Persistent complex bereavement disorder (PCBD) is a disorder of grief that newly entered DSM-5. Prolonged Grief Disorder (PGD) is a disorder of grief included in ICD-11. No prior studies examined and compared the dimensionality, prevalence, and concurrent validity of both conditions among bereaved children.Methods: With data from 291 help-seeking bereaved 8-18 year old children, we used confirmatory factor analysis to evaluate the fit of different factor models for PCBD and PGD. In addition, we determined diagnostic rates for probable PCBD and PGD and calculated associations of PCBD and PGD caseness with concurrently assessed symptoms of overall disturbed grief, depression, posttraumatic stress, and parent-rated problem behaviour.Results: For PCBD and PGD, one-factor models—with all symptoms forming a unidimensional factor of disturbed grief—fit the data best. The prevalence of probable DSM-5 PCBD (3.4%) was significantly lower than ICD-11 PGD (12.4%). Both PCBD and PGD were significantly associated with concurrently assessed overall disturbed grief, depression, and posttraumatic stress; associations with parent-rated problems were moderate.Limitations: Findings were based on self-reported ratings of symptoms, obtained from three different scales not specifically designed to assess PCBD and PGD. The use of a help-seeking sample limits the generalization of findings to bereaved children generally.Conclusions: Findings support the validity of DSM-5 PCBD and ICD-11 PGD. Prevalence rates of both constructs differ. This needs further scrutiny.
  • Longitudinal association of PTSD symptoms and self-reported physical
           functioning among Veterans
    • Abstract: Publication date: Available online 19 February 2019Source: Journal of Affective DisordersAuthor(s): Ashkan J. Ahmadian, Thomas C. Neylan, Thomas Metzler, Beth E. Cohen BackgroundFew longitudinal studies have investigated the potentially dynamic relationship between Posttraumatic Stress Disorder (PTSD) and physical functioning, and the number of follow-up timepoints have been limited. We evaluated whether PTSD symptoms predicted future physical functioning and vice versa using five assessments over four years.MethodsData was used from a longitudinal cohort of 695 participants recruited from Veteran Affairs medical outpatient clinics who experienced a traumatic event. PTSD symptom severity was assessed annually with the PTSD Checklist (PCL). Physical functioning was measured with the 10-item subscale of the SF-36. An autoregressive cross-lagged panel model was used to determine the temporal associations between PTSD and physical functioning, adjusting for age, sex, ethnicity, education and employment. Comorbidities and health behaviors were added to assess their roles in the relationship.ResultsGreater PTSD symptom severity predicted worse physical functioning the following year (average β = –0.10, P
  • Clinically relevant anxiety and risk of Alzheimer's disease in an elderly
           community sample: 4.5 years of follow-up.
    • Abstract: Publication date: Available online 19 February 2019Source: Journal of Affective DisordersAuthor(s): J. Santabárbara, B. Villagrasa, R. Lopez-Anton, B. Olaya, J. Bueno-Notivol, C. de la Cámara, P. Gracia-García, E. Lobo, A. Lobo Objectives: To investigate whether clinically relevant anxiety increased the risk for developing Alzheimer's disease (AD) while controlling for the presence of depression and other confounders; and to report the population attributable fraction (PAF) associated with anxiety disorder.Method: We used data from the longitudinal, community-based Zaragoza Dementia and Depression (ZARADEMP) study. A random sample of 4,057 dementia-free community dwellers aged 55 or older were followed for 4.5 years. The Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy package was used for the diagnosis of clinically significant cases and subcases of anxiety; and AD was diagnosed by a panel of research psychiatrists according to DSM-IV criteria. Multivariate survival analysis with competing risk regression model was performed.Results: We observed a significant association between anxiety cases at baseline and AD risk in the univariate analysis that persisted in the fully adjusted model (SHR: 3.90; 95% CI: 1.59 - 9.60; p=0.003), with a PAF for AD of 6.11% (95% CI: 1.30% - 16.17%). No significant association between ‘subcases’ of anxiety at baseline and AD was found.Limitations: Data on apolipoprotein E were not available. The hospital-based diagnosis was not completed in all cases of dementia.Conclusion: Late life, clinically significant anxiety (but not subclinical anxiety) seems to increase the risk of AD, independently of the effect of several confounders, including depression. Taking into account the high prevalence of anxiety among the elderly, future studies are warranted to determine potential risk reduction of AD.
  • Adjunctive ketamine and electroconvulsive therapy for major depressive
           disorder: a meta-analysis of randomized controlled trials
    • Abstract: Publication date: Available online 18 February 2019Source: Journal of Affective DisordersAuthor(s): Wei Zheng, Xiao-Hong Li, Xiao-Min Zhu, Dong-Bin Cai, Xin-Hu Yang, Gabor S. Ungvari, Chee H. Ng, Yu-Ping Ning, Yong-Dong Hu, Shu-Hua He, Gang Wang, Yu-Tao Xiang BackgroundAdjunctive ketamine of electroconvulsive therapy (ECT) has been investigated for treating major depressive disorder (MDD), but the findings have been inconsistent.AimThis is an updated meta-analysis of the efficacy and safety of ketamine augmentation of ECT in the treatment of MDD.MethodsRandomized controlled trials (RCTs) reporting on the efficacy and safety of ketamine and ECT were identified and analyzed.ResultsSeventeen RCTs (n=1,035) compared ketamine alone or ketamine plus other anesthetic drugs (n=557) with other anesthetic agents (n=478) in MDD patients who received ECT. Ketamine+other anesthetics drug was superior in improving depressive symptoms over other anesthetic medications at early study time point, but not at post-ECT or end of study time points. Ketamine alone was not more efficacious in treatinging depressive symptoms than other anesthetic drugs at early study, post-ECT and end of study time points. Sensitivity analysis and 19 of the 20 subgroup analyses also confirmed the lack of significance of these findings. Eleven RCTs testing the effects of ketamine on neurocognitive functions with various test batteries found mixed results. Ketamine alone significantly increased blood pressure more than other anesthetic drugs in MDD treated with ECT.ConclusionCompared to other anesthetic agents, ketamine alone does not appear to improve the efficacy of ECT. However, ketamine+other anesthetic combinations may confer a short-term advantage in improving depressive symptom at the early stages of ECT.
  • Treatment effects on residual cognitive symptoms among partially or fully
           remitted patients with major depressive disorder: A randomized,
           double-blinded, exploratory study with vortioxetine
    • Abstract: Publication date: Available online 6 February 2019Source: Journal of Affective DisordersAuthor(s): A.A. Nierenberg, H. Loft, C.K. Olsen BackgroundResidual cognitive symptoms in major depressive disorder (MDD) are common, yet poorly investigated. We explored the effectiveness of vortioxetine as adjunctive treatment to selective serotonin reuptake inhibitors (SSRI) and as monotherapy versus continued SSRI, in patients with MDD who achieved full or partial remission with SSRI, but report residual cognitive symptoms.MethodsPatients (18-65 years old, N=151) diagnosed with MDD, with a Hamilton Depression Rating Scale 17-items total score ≤10 and a Perceived Deficits Questionnaire–Depression total score>25, were randomized 1:1:1 to 8 weeks of double-blind treatment with current SSRI + placebo, SSRI + vortioxetine (10-20 mg/day), or vortioxetine (10-20 mg/day) + placebo. The primary efficacy measure was the Digit Symbol Substitution Test (DSST), analyzed using a mixed model for repeated measurements. Secondary outcomes comprised cognitive functioning, subjectively-rated cognitive symptoms, patient functioning, and mood symptoms.ResultsFrom baseline to week 8, all treatment groups improved DSST performance, with statistically nonsignificant treatment differences. Similar results were seen for secondary endpoints. Improvement in cognitive performance tended to be numerically larger with vortioxetine monotherapy than with SSRI monotherapy, while vortioxetine as adjunctive treatment tended to perform numerically better in further improving depressive symptoms. Most adverse events were mild or moderate. Nausea was the most common adverse event for vortioxetine.LimitationsSmall sample sizes limited statistical power.ConclusionIn this explorative study, remitted patients with MDD improved their cognitive performance with no treatment differences. Secondary results indicate numerical benefits for cognitive performance with vortioxetine monotherapy, and for depressive symptoms with vortioxetine augmentation.
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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